Provider Demographics
NPI:1285078394
Name:TUCKER, MARIA WURSTER (DO)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:WURSTER
Last Name:TUCKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11700 W 2ND PL STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1707
Mailing Address - Country:US
Mailing Address - Phone:720-321-8230
Mailing Address - Fax:720-321-8231
Practice Address - Street 1:11700 W 2ND PL STE 1000
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1704
Practice Address - Country:US
Practice Address - Phone:720-321-8460
Practice Address - Fax:303-321-8231
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WYTL58862085R0202X
NMA-2133-182085R0202X
NE20572085R0202X
CODR.00626552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology