Individual
GARRETT DAVID RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 388-3000
Mailing address
PO BOX 1980, NORFOLK, VA 23501-1980
(757) 388-1141
(757) 388-1140
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0116038107
VA
Other
Enumeration date
03/28/2022
Last updated
06/29/2023
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