Active NPI
Mark H Tucker, MD
- Pediatrics Physician
- Dearborn, MI
National Provider Identifier
1598704652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301037522
- Practice address
- 5050 Schaefer Rd
Dearborn, MI 48126-3249 - Phone
- (313) 581-2600
- Fax
- (313) 581-0228
- NPI assigned
- Jun 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301037522 | MI | Primary |
Addresses
Primary practice location
5050 Schaefer Rd
Dearborn, MI 48126-3249
Mailing address
143 Forest Glen Dr
Holland, OH 43528-9207
Phone (419) 861-0008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024244 | Other | MI | MIDWEST HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301037522 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1598704652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 FOREST GLEN DR",
"city": "HOLLAND",
"state": "OH",
"postal_code": "435289207",
"telephone_number": "419-861-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 SCHAEFER RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263249",
"telephone_number": "313-581-2600",
"fax_number": "313-581-0228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "MARK",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-05",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301037522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDWEST HEALTH PLAN",
"identifier": "024244",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.