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Individual

DR. CHARLES CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-6200
(505) 727-9590
Mailing address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-6200
(505) 727-9590

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
85155
NM
207Q00000X
Family Medicine Physician
Primary
85-155
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37598
NM
Enumeration date
03/21/2006
Last updated
04/17/2017
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