Provider Demographics
NPI:1427492776
Name:SNOWBERGER, CAROLINE KELLY (DO)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:KELLY
Last Name:SNOWBERGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 FOULK RD STE 100B
Mailing Address - Street 2:CHRISTIANA CARE HEALTH SYSTEM
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2764
Mailing Address - Country:US
Mailing Address - Phone:302-477-3300
Mailing Address - Fax:
Practice Address - Street 1:1401 FOULK RD STE 100B
Practice Address - Street 2:CHRISTIANA CARE HEALTH SYSTEM
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2764
Practice Address - Country:US
Practice Address - Phone:302-477-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DEC7-0005387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program