Provider Demographics
NPI:1437105418
Name:SAMUEL S THATCHER MD, PHD
Entity Type:Organization
Organization Name:SAMUEL S THATCHER MD, PHD
Other - Org Name:CENTER FOR APPLIED REPRODUCTIVE SCIENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:THATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-285-8881
Mailing Address - Street 1:520 BILTMORE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4602
Mailing Address - Country:US
Mailing Address - Phone:828-285-8881
Mailing Address - Fax:828-258-8887
Practice Address - Street 1:520 BILTMORE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4602
Practice Address - Country:US
Practice Address - Phone:828-285-8881
Practice Address - Fax:828-258-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001257205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0288TOtherBCBS PROVIDER NUMBER
NC89-0288TMedicaid
NC89-0288TMedicaid