Individual
DR. MICHAEL L TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 KINGSLEY LN, STE 411, NORFOLK, VA 23505-4618
(757) 625-3777
(757) 625-7411
Mailing address
110 KINGSLEY LN, STE 411, NORFOLK, VA 23505-4618
(757) 625-3777
(757) 625-7411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101047711
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5605024
—
VA
Enumeration date
08/14/2006
Last updated
08/26/2020
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