Provider Demographics
NPI:1528721867
Name:SNOVER, JOEL CHARLES (PA-C)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:CHARLES
Last Name:SNOVER
Suffix:
Gender:M
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 1:7804 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-1702
Mailing Address - Country:US
Mailing Address - Phone:313-388-0033
Mailing Address - Fax:313-388-1188
Practice Address - Street 1:7804 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1702
Practice Address - Country:US
Practice Address - Phone:313-388-0033
Practice Address - Fax:313-388-1188
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601011288363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical