Provider Demographics
NPI:1164467502
Name:RUEGG, ROBERT GEORGE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:RUEGG
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1333 IRIS AVE
Mailing Address - Street 2:MHP
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304
Mailing Address - Country:US
Mailing Address - Phone:303-413-6212
Mailing Address - Fax:303-413-6325
Practice Address - Street 1:529 COFFMAN ST
Practice Address - Street 2:#300
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:303-684-0555
Practice Address - Fax:970-336-5000
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2016-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO196972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01196971Medicaid
COD92787Medicare UPIN
CO01196971Medicaid
COCO303762Medicare PIN