Provider Demographics
NPI:1063153732
Name:SNEDEGAR, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SNEDEGAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 KANAWHA TER
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-3041
Mailing Address - Country:US
Mailing Address - Phone:304-541-2118
Mailing Address - Fax:
Practice Address - Street 1:1355 KANAWHA TER
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-3041
Practice Address - Country:US
Practice Address - Phone:304-541-2118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant