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Individual

JEREMY RAY CHASTAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(405) 659-4962
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD2024-0731
NM
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD2024-0731
NM

Other

Enumeration date
06/21/2012
Last updated
12/04/2024
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