Provider Demographics
NPI:1902913015
Name:SNYDER, LINDA B (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:B
Last Name:SNYDER
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 1:8604 CLIFF CAMERON DR STE 152
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8526
Mailing Address - Country:US
Mailing Address - Phone:704-510-5600
Mailing Address - Fax:704-510-5601
Practice Address - Street 1:8604 CLIFF CAMERON DR STE 152
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-8526
Practice Address - Country:US
Practice Address - Phone:704-510-5600
Practice Address - Fax:704-510-5601
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-011832084P0804X
TN0301372084P0804X
MS244102084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7617521Medicaid
TN3719897Medicaid
NC7617521Medicaid
TN3719897Medicaid