Provider Demographics
NPI:1366648404
Name:CHABOT-RICHARDS, DEVON S (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:S
Last Name:CHABOT-RICHARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1220 FORRESTER AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-2185
Mailing Address - Country:US
Mailing Address - Phone:505-715-8471
Mailing Address - Fax:
Practice Address - Street 1:1001 WOODWARD NE
Practice Address - Street 2:TRICORE REFERENCE LABORATORIES
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102
Practice Address - Country:US
Practice Address - Phone:505-272-4814
Practice Address - Fax:505-272-8084
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2011-0135207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology