Provider Demographics
NPI:1902887318
Name:SNIDER, ANNE AL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:AL
Last Name:SNIDER
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 1:3600 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-7595
Mailing Address - Country:US
Mailing Address - Phone:515-239-4492
Mailing Address - Fax:515-663-4836
Practice Address - Street 1:3600 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7595
Practice Address - Country:US
Practice Address - Phone:515-239-4492
Practice Address - Fax:515-663-4836
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36038207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0461608Medicaid
IAI15588Medicare ID - Type Unspecified
IAI36088Medicare UPIN