Individual
JOHN MICHAEL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2017-00573
NC
207R00000X
Internal Medicine Physician
Primary
52142
SC
Other
Enumeration date
04/18/2014
Last updated
08/02/2018
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