Provider Demographics
NPI:1225065113
Name:RUGGIERI, PAUL A (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:RUGGIERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 PRESIDENT AVE
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5923
Mailing Address - Country:US
Mailing Address - Phone:508-676-3411
Mailing Address - Fax:508-676-0932
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 3002
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-676-3411
Practice Address - Fax:508-676-0932
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA158145208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0027848OtherNHP
1700566OtherUHC
9461208 002OtherCIGNA FOR REFERRALS
020045787OtherRAILROAD MED
RIPR28496Medicaid
MA020045787OtherRAILROAD MEDICARE
807888OtherHPHC
000369OtherSWH
2093283OtherAETNA
MA3189392Medicaid
B20914802OtherCIGNA
J19613OtherMASS BS
000000021263OtherBMC
158145OtherTUFTS
403436OtherBLUE CHIP
MAJ19613OtherBLUE CROSS BLUE SHIELD
158145OtherTUFTS
J19613OtherMASS BS
0027848OtherNHP