Provider Demographics
NPI:1912722083
Name:THATCHER, CHARLES AUGUSTUS III
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:AUGUSTUS
Last Name:THATCHER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BURTON WAY
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713-2077
Mailing Address - Country:US
Mailing Address - Phone:724-344-3496
Mailing Address - Fax:
Practice Address - Street 1:208 BURTON WAY
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-2077
Practice Address - Country:US
Practice Address - Phone:724-344-3496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool