Organization
SILVER BIRCH MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN STERLING TUCKER MD (OWNER/PHYSICIAN OWNER)
(860) 951-2198
Entity
Organization
Contact information
Practice address
15 PALOMBA DR, ENFIELD, CT 06082-3888
(860) 951-2198
Mailing address
71 W STAFFORD RD STE 4A, STAFFORD SPRINGS, CT 06076-1069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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