Provider Demographics
NPI:1366852550
Name:PUGLISI, ABIGAIL K (DO)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:K
Last Name:PUGLISI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:K
Other - Last Name:KOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 MEMORIAL DR STE 1200
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:WI
Practice Address - Zip Code:54923-1243
Practice Address - Country:US
Practice Address - Phone:920-361-5770
Practice Address - Fax:920-361-5779
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI65026207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program