Provider Demographics
NPI:1841558079
Name:GODSHALK RUGGLES, ASHLEE NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:NICOLE
Last Name:GODSHALK RUGGLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:NICOLE
Other - Last Name:GODSHALK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:6560 FANNIN ST STE 1404
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2706
Mailing Address - Country:US
Mailing Address - Phone:713-790-0600
Mailing Address - Fax:
Practice Address - Street 1:2 CAPITAL WAY STE 356
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-537-6000
Practice Address - Fax:609-537-6002
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10648800208600000X, 208C00000X
PAMD468677208600000X, 208C00000X
TXR2857208600000X
NHR2333208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208800000XAllopathic & Osteopathic PhysiciansUrology