Individual
ELLIOT MOORE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7213
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7213
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
0101234827
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02032548
—
MS
05
—
1193186
—
LA
05
—
1265639306
—
VA
05
—
89066JW
—
NC
Enumeration date
07/02/2007
Last updated
12/19/2012
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