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General NPI Number Information
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NPI Number | 1720061450
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Entity Type | Individual
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Provider Name | CHAD M BIDART M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 407 S SCHWARTZ AVE STE 202
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City | FARMINGTON
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State | NM
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Zip | 87401-5925
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Country | US
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Telephone | 505-609-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 27 ENGINE CREEK TRL
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City | DURANGO
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State | CO
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Zip | 81301-8536
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Country | US
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Telephone | 775-772-1494
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Fax | 775-772-1494
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 12296
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 12296
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | MD2019-0474
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License Number State | NM
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