Provider Demographics
NPI:1194718296
Name:SNYDER, KAMILIA (MD)
Entity type:Individual
Prefix:DR
First Name:KAMILIA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 PIERCE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009
Mailing Address - Country:US
Mailing Address - Phone:248-645-1740
Mailing Address - Fax:248-645-5304
Practice Address - Street 1:503 PIERCE ST
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-1751
Practice Address - Country:US
Practice Address - Phone:248-645-1740
Practice Address - Fax:248-645-5304
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKS038090208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5201266OtherAETNA
MIC5892OtherMCARE
MID91401OtherHEALTH ALLIANCE PLAN
MIP88821OtherBLUE CARE NETWORK
MI4262174Medicaid
MID91401OtherHEALTH ALLIANCE PLAN