Provider Demographics
NPI:1487069605
Name:SNYDER, MELANIE SARA (PA-C)
Entity type:Individual
Prefix:MISS
First Name:MELANIE
Middle Name:SARA
Last Name:SNYDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 BOONE BLVD STE 430
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2646
Mailing Address - Country:US
Mailing Address - Phone:703-255-5070
Mailing Address - Fax:
Practice Address - Street 1:8230 BOONE BLVD STE 430
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2646
Practice Address - Country:US
Practice Address - Phone:032-555-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005653363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical