# SHADY GROVE ORTHOPAEDIC ASSOC, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033861711
- **Authorized official:** STEVEN TUCK MD (ORTHOPAEDIC SURGEON/ M.D.)
- **Authorized official phone:** (301) 340-9200

## Contact information

- **Practice address:** 19735 GERMANTOWN RD STE 120, GERMANTOWN, MD 20874-1225
- **Practice address phone:** (301) 340-9200
- **Mailing address:** 9601 BLACKWELL RD STE 100, ROCKVILLE, MD 20850-6477

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/24/2022
- **Last updated:** 02/24/2022