Provider Demographics
NPI:1376991802
Name:BRIZENDINE, CHAD T (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:T
Last Name:BRIZENDINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 W IRONWOOD DR STE 378
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4401
Mailing Address - Country:US
Mailing Address - Phone:208-625-3555
Mailing Address - Fax:208-769-8616
Practice Address - Street 1:700 W IRONWOOD DR STE 378
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4401
Practice Address - Country:US
Practice Address - Phone:208-625-3555
Practice Address - Fax:208-769-8616
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM-16208207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease