Individual
DR. STEVEN RICHARD TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9001 DIGGES RD STE 206, MANASSAS, VA 20110-4414
(703) 330-6440
(703) 369-5819
Mailing address
9001 DIGGES RD STE 206, MANASSAS, VA 20110-4414
(703) 330-6440
(703) 369-5819
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101043908
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100025
ANTHEM BLUE SHIELD
VA
05
—
5603641
—
VA
01
—
7212-0001
CAREFIRST BLUECHOICE
VA
Enumeration date
08/20/2006
Last updated
01/14/2008
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