Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D24742 | MD |
NPI | 1184610719 |
---|---|
Provider Name | Dr. Steven W Tucker |
First Address | Towson, MD 21204-7536 |
Second Address | Towson, MD 21204-7536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 25/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
442271601 | (05) | MD |
D76604 | (02) | MD |