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Individual

CAREY GRAHAM TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
955 RIBAUT RD, BEAUFORT, SC 29902-5441
(877) 532-6472
Mailing address
PO BOX 601495, CHARLOTTE, NC 28260-1495
(843) 789-1620
(843) 724-2454

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1910
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1622PA
SC
Enumeration date
03/13/2013
Last updated
11/09/2020
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