Provider Demographics
NPI:1194925545
Name:TUCKER, RUBY M (MD)
Entity type:Individual
Prefix:DR
First Name:RUBY
Middle Name:M
Last Name:TUCKER
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:5516 VIRGINIA BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5629
Mailing Address - Country:US
Mailing Address - Phone:757-473-3969
Mailing Address - Fax:757-506-0157
Practice Address - Street 1:5516 VIRGINIA BEACH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5629
Practice Address - Country:US
Practice Address - Phone:757-473-3969
Practice Address - Fax:757-506-0157
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101225807207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101225807OtherSTATE LICENSE