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Individual

WILLIAM MARTIN TUCKER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
119 SPRINGHALL DR, GOOSE CREEK, SC 29445-5368
(843) 266-2520
(843) 553-4436
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
26336
SC
207Q00000X
Family Medicine Physician
Primary
26336
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
263360
SC
Enumeration date
10/27/2006
Last updated
06/08/2021
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