Provider Demographics
NPI:1518386390
Name:PUGLIESE, MAURIZIO (DO)
Entity Type:Individual
Prefix:
First Name:MAURIZIO
Middle Name:
Last Name:PUGLIESE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-1596
Mailing Address - Country:US
Mailing Address - Phone:608-417-3886
Mailing Address - Fax:
Practice Address - Street 1:MERITER HOSPITAL, INC
Practice Address - Street 2:8102 WELLNESS WAY
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-417-8777
Practice Address - Fax:608-417-8757
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005697A2084P0800X
WI65371-212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry