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NPI Code Detail

MEDICARE: CHAD C PUFFER DO

MEDICARE: CHAD C PUFFER DO
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0804XChild & Adolescent Psychiatry Physician55432MN
32084P0800XPsychiatry Physician55432MN

General Provider Information

NPI Number : 1619263985
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD C PUFFER DO
Provider Business Mailing Address
First Line : 5255 MEMBERS PKWY NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-8381
Country : US
Telephone Number : 507-218-3701
Fax Number :
Provider Business Practice Location Address
First Line : 5255 MEMBERS PKWY NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-8381
Country : US
Telephone Number : 507-218-3701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2011
Last Update Date : 10/08/2019

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