Provider Demographics
NPI:1942338918
Name:PUGLIESE, DOUGLAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:PUGLIESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD.
Mailing Address - Street 2:1-330S PERELMAN CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-2737
Mailing Address - Fax:215-615-3424
Practice Address - Street 1:3400 CIVIC CENTER BLVD.
Practice Address - Street 2:1-330S PERELMAN CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-2737
Practice Address - Fax:215-615-3424
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2017-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD444898207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology