MEDICARE: DR. CHAD SMELSER 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
1	208000000X	Pediatrics Physician	2003-0420	NM

General Provider Information

NPI Number	:	1255479309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD SMELSER M.D.

Provider Business Mailing Address
First Line	:	1958 TIJERAS RD
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-3352
Country	:	US
Telephone Number	:	505-982-8834
Fax Number	:

Provider Business Practice Location Address
First Line	:	1190 ST FRANCIS DR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87502
Country	:	US
Telephone Number	:	505-476-3019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	07/08/2007

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