Provider Demographics
NPI:1255404786
Name:RUGGLES, SETH M (DO)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:M
Last Name:RUGGLES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1031 PIERCE STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870
Mailing Address - Country:US
Mailing Address - Phone:419-557-5541
Mailing Address - Fax:419-557-5542
Practice Address - Street 1:348 MILAN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-0000
Practice Address - Country:US
Practice Address - Phone:419-668-4567
Practice Address - Fax:419-668-4568
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2012-09-11
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Provider Licenses
StateLicense IDTaxonomies
OH34008967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4218701Medicare PIN
RES000Medicare UPIN