Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD84172 | SC |
NPI | 1053843524 |
---|---|
Provider Name | Ana Elizabeth Tucker |
First Address | Charleston, SC 29425-8905 |
Second Address | Charleston, SC 29425-2734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2017 |
Last Update Date | 22/09/2020 |