Individual
DR. GLENN ALAN TUCKER
Active
Individual
DR. GLENN ALAN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
204979
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204979
TUFTS
MA
05
—
3208745
—
MA
01
—
AA78836
HPHC
MA
01
—
J22406
MABCBS
MA
Enumeration date
10/12/2006
Last updated
05/07/2021
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