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General NPI Number Information
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NPI Number | 1578856233
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Entity Type | Individual
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Provider Name | CHAD BERRYMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 1 UNIVERSITY OF NEW MEXICO
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-2707
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Country | US
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Telephone | 505-272-3942
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Fax |
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Provider Business Mailing Address
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Address Line | 535 MULBERRY ST SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-5265
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Country | US
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Telephone | 575-621-2829
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | RS2017-0741
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD2018-0016
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License Number State | NM
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