Orl PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

01016604A Issued in IN

Legal business name

ORL PC

Practice address

800 Broadway
Ste 207
Fort Wayne, IN 46802-2149

Phone

(260) 422-2386

Fax

(260) 422-3985

NPI assigned

Sep 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sanford C Snyderman, MD

Title

Secretary

Phone

(260) 422-2386

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508960774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BROADWAY",
            "address_2": "STE 207",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022149",
            "telephone_number": "260-422-2386",
            "fax_number": "260-422-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BROADWAY",
            "address_2": "STE 207",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468022149",
            "telephone_number": "260-422-2386",
            "fax_number": "260-422-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SNYDERMAN",
        "authorized_official_first_name": "SANFORD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "260-422-2386",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01016604A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000085958",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Otolaryngology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.