Healthcare Provider Details

I. General information

NPI: 1912587494
Provider Name (Legal Business Name): SCOTT M TUCKER MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 SAINT PAUL ST
BALTIMORE MD
21202-2123
US

IV. Provider business mailing address

1205 LIMERICK CT
HUMMELSTOWN PA
17036-9152
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMT224183
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: