Individual
CHARIS THATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 595-7886
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
104589
MN
207P00000X
Emergency Medicine Physician
51347
CO
Other
Enumeration date
05/21/2008
Last updated
07/26/2012
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