Provider Demographics
NPI:1386832970
Name:COLE, CHAD DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:DOUGLAS
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:MSC10 5615
Mailing Address - Street 2:1 UNVIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:505-272-3401
Mailing Address - Fax:505-272-6091
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-1530
Practice Address - Country:US
Practice Address - Phone:505-272-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT294901-1205207T00000X
NY290897-1207T00000X
WI55955207T00000X
NMMD2020-0136207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery