Basic Information
| Provider Information | |||||||||
| NPI: | 1326272584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAFEY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | HOLMES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 933 BRADBURY DRIVE SE, SUITE 2222 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871064374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052723120 | ||||||||
| FaxNumber: | 5052728060 | ||||||||
| Practice Location | |||||||||
| Address1: | THE UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE | ||||||||
| Address2: | DEPT OF ORTHOPAEDICS, MSC 10-5600, 1 UNIVERSITY OF NM | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052728301 | ||||||||
| FaxNumber: | 5052728098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2009 | ||||||||
| LastUpdateDate: | 09/11/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2012-0566 | NM | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0801X | 2012-0566 | NM | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
ID Information
| ID | Type | State | Issuer | Description | 533111 | 05 | AZ | MEDICAID |