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Individual

DR. ELRIE CHRISTIAN TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9500 EUCLID AVE, MAIL CODE P21, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
9500 EUCLID AVE, MAIL CODE P21, CLEVELAND, OH 44195-0001
(800) 223-2273

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35-072176
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000205929
ANTHEM PROVIDER
OH
05
212072
OH
Enumeration date
05/18/2006
Last updated
05/29/2008
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