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General NPI Number Information
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NPI Number | 1619077120
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Entity Type | Individual
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Provider Name | MICHAEL PAUL CHAMBERS PA
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 2425 RIDGECREST DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5129
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Country | US
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Telephone | 505-717-3262
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Fax |
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Provider Business Mailing Address
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Address Line | 3105 NIESE CT SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87121-6973
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Country | US
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Telephone | 505-515-5554
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2013-0079
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License Number State | NM
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