Provider Demographics
NPI:1730781170
Name:SNODGRASS, MICHAEL DEAN (CRNA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DEAN
Last Name:SNODGRASS
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 MIDLOTHIAN TPKE STE 265
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4700
Mailing Address - Country:US
Mailing Address - Phone:804-594-2622
Mailing Address - Fax:804-595-0915
Practice Address - Street 1:10800 MIDLOTHIAN TPKE STE 265
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4700
Practice Address - Country:US
Practice Address - Phone:804-594-2622
Practice Address - Fax:804-595-0915
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180905367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered