Individual
MICHAEL C TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 200, COLUMBIA, SC 29203-6882
(803) 296-7846
(803) 296-9699
Mailing address
PO BOX 22265, BELFAST, ME 04915-4473
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
039968
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000655157A
—
GA
05
—
G39968
—
SC
Enumeration date
08/31/2006
Last updated
03/09/2018
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