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NPI Code Detail

MEDICARE: STANLEY C TUCKER MD

MEDICARE:   STANLEY C TUCKER  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician0101019973VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528027802
Entity Type Code : Individual
Provider Name (Legal Business Name) : STANLEY C TUCKER MD
Provider Business Mailing Address
First Line : 8401 N RUN MEDICAL DR
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2309
Country : US
Telephone Number : 804-559-9902
Fax Number : 804-559-9904
Provider Business Practice Location Address
First Line : 8401 N RUN MEDICAL DR
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2309
Country : US
Telephone Number : 804-559-9902
Fax Number : 804-559-9904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 08/09/2019

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Directions to “ STANLEY C TUCKER MD” Practice Location

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