Healthcare Provider Details

I. General information

NPI: 1013974591
Provider Name (Legal Business Name): MARGARET ANNE TUCKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 EXECUTIVE BLVD EXECUTIVE PLAZA SOUTH 7122
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

6120 EXECUTIVE BLVD EXECUTIVE PLAZA SOUTH 7122
BETHESDA MD
20892-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-4375
  • Fax: 301-402-4489
Mailing address:
  • Phone: 301-496-4375
  • Fax: 301-402-4489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD0038024
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: