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NPI Code Detail

MEDICARE: DR. GERZAIN CHAVEZ M.D.

MEDICARE: DR. GERZAIN CHAVEZ M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician98-28NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NM029008OTHERNMBCBS NM
22191728OTHERUHC
3QMYPRO0074100OTHERNMMOLINA
4202014955OTHERPRESBYTERIAN HEALTH PLAN
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194837120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERZAIN CHAVEZ M.D.
Provider Business Mailing Address
First Line : 4001 RODEO RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4830
Country : US
Telephone Number : 505-471-8994
Fax Number : 505-473-1274
Provider Business Practice Location Address
First Line : 4001 RODEO RD
Second Line :
City : SANTA FE
State : NM
Zip : 87507-4830
Country : US
Telephone Number : 505-471-8994
Fax Number : 505-473-1274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 09/03/2013

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