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General NPI Number Information
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NPI Number | 1922095504
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Entity Type | Individual
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Provider Name | THATCHER ROYAL CARDON M.D., MBA, CPE
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 2480 LLEWELLYN AVE
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City | FORT GEORGE G MEADE
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State | MD
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Zip | 20755-7081
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Country | US
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Telephone | 301-619-7511
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Fax |
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD066052L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00041986
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License Number State | WA
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