Individual
CHAD BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5111 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87111-2672
(505) 880-1000
(505) 880-1002
Mailing address
5111 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87111-2672
(505) 880-1000
(505) 880-1002
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
289
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10004402
LOVELACE
NM
01
—
181866400
ESA
NM
01
—
201042850
PRESBITERIAN
NM
01
—
4583990001
DME
NM
01
—
536064075
AETNA
NM
01
—
NM005490
BLUES
NM
01
—
P00078790
RAILROAD MCR
—
01
—
PROVB11359
MOLINA
NM
Enumeration date
08/09/2006
Last updated
05/24/2011
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