Individual
MICHAEL BRIAN STUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
301 RIVERVIEW AVE STE 700, NORFOLK, VA 23510-1065
(757) 252-9365
Mailing address
301 RIVERVIEW AVE STE 700, NORFOLK, VA 23510-1065
(757) 252-9365
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009402
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
12/28/2022
Last updated
09/28/2023
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