Basic Information
Provider Information
NPI: 1972861680
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNOWDEN
FirstName: RYAN
MiddleName: DANE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9118
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554809118
CountryCode: US
TelephoneNumber: 6153292294
FaxNumber: 6156951494
Practice Location
Address1: 8 CITY BLVD STE 300
Address2:  
City: NASHVILLE
State: TN
PostalCode: 37209
CountryCode: US
TelephoneNumber: 6153296600
FaxNumber: 6153294858
Other Information
ProviderEnumerationDate: 05/01/2012
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X01078424AINN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000XR3113KYN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000X57515TNN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0117X01078424AINN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
207XS0117X57515TNY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine

ID Information
IDTypeStateIssuerDescription
Q03721905TN MEDICAID


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