Healthcare Provider Details

I. General information

NPI: 1184244469
Provider Name (Legal Business Name): DAVID CHANDLER HYER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2020
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CARMEL AVE NE STE 501
ALBUQUERQUE NM
87122-5180
US

IV. Provider business mailing address

4433 WALDEN LN NE
ALBUQUERQUE NM
87111
US

V. Phone/Fax

Practice location:
  • Phone: 505-717-1274
  • Fax:
Mailing address:
  • Phone: 702-460-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD22005
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD22005
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: