Provider Demographics
NPI:1942610647
Name:TUCKER, ANNA HARPER (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:HARPER
Last Name:TUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ELISE
Other - Last Name:HARPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 SPRINGHALL DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-5351
Mailing Address - Country:US
Mailing Address - Phone:843-766-6308
Mailing Address - Fax:866-533-4473
Practice Address - Street 1:105 SPRINGHALL DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-5351
Practice Address - Country:US
Practice Address - Phone:843-766-6308
Practice Address - Fax:866-533-4473
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00910208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics