Provider Demographics
NPI:1861621799
Name:SNIDER, STEVEN MICHAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:SNIDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9062 HACKBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4111
Mailing Address - Country:US
Mailing Address - Phone:734-968-6117
Mailing Address - Fax:
Practice Address - Street 1:35363 FORD RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3171
Practice Address - Country:US
Practice Address - Phone:734-728-7392
Practice Address - Fax:734-728-2582
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist