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Kenneth Tucker, MD
Hematology & Oncology Physician in Warren, Michigan
NPI 1669479846

Kenneth Tucker is a Hematology & Oncology Physician based in Warren, MI and is specialized in Hematology & Oncology. Kenneth Tucker practices in Warren, MI and has the professional credentials of MD. The NPI Number for Kenneth Tucker is 1669479846 and holds a License No. 4301024231 (Michigan).

The current practice location address for Kenneth Tucker is 11900 E 12 Mile Rd, Warren, MI and can be reached out via phone at 586-751-2072 and via fax at 586-751-1302.

Location: 11900 E 12 Mile Rd, Warren, MI, 48093-3400
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669479846
Provider Name
Kenneth Tucker
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
11900 E 12 Mile Rd, Warren, MI, 48093-3400
Phone Number
586-751-2072
Fax Number
586-751-1302
Provider Enumeration Date
07/05/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
700H273300 01 MI BCBSM
1672544 05 MI
KT024231 01 MI BCBSM OTHER IDENTIFIER
institution
Provider Business Practice Location Address Details
Address
11900 E 12 Mile Rd
City
Warren
State
Michigan
Zip
48093-3400
Phone Number
586-751-2072
Fax Number
586-751-1302
person
Provider Business Mailing Address Details
Address
11900 E 12 Mile Rd
City
Warren
State
Michigan
Zip
48093-3400
Phone Number
586-751-2072
Fax Number
586-751-1302
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Hematology & Oncology
Taxonomy
207RH0003X
License No.
4301024231 (Michigan)
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
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11900 E 12 Mile Rd,
WARREN, MI
48093-3400
586-751-2072
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