Provider Demographics
NPI:1255479309
Name:SMELSER, CHAD (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:SMELSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 TIJERAS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3352
Mailing Address - Country:US
Mailing Address - Phone:505-982-8834
Mailing Address - Fax:
Practice Address - Street 1:1190 ST FRANCIS DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87502
Practice Address - Country:US
Practice Address - Phone:505-476-3019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2003-0420208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics