Provider Demographics
NPI:1427053149
Name:SNYDER, STEVEN KEITH (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:KEITH
Last Name:SNYDER
Suffix:
Gender:M
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:PO BOX 1290
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1290
Mailing Address - Country:US
Mailing Address - Phone:434-385-5600
Mailing Address - Fax:
Practice Address - Street 1:109 WIMBLEDON SQ
Practice Address - Street 2:STE E
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4945
Practice Address - Country:US
Practice Address - Phone:757-547-9830
Practice Address - Fax:757-548-0721
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052662207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAANTHEM BC/BSOther250680
VA180027441OtherRR MEDICARE
NY890624MOtherNMC MEDICAID
VA15575OtherOPTIMA
VA6302301Medicaid
VA180000558Medicare ID - Type UnspecifiedMEDICARE
VA6302301Medicaid