Provider Demographics
NPI:1295751600
Name:RUGGEROLI, ANTHONY CHARLES (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHARLES
Last Name:RUGGEROLI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9159 W FLAMINGO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6454
Mailing Address - Country:US
Mailing Address - Phone:702-307-7700
Mailing Address - Fax:702-307-7942
Practice Address - Street 1:9159 W FLAMINGO RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6454
Practice Address - Country:US
Practice Address - Phone:702-307-7700
Practice Address - Fax:702-307-7942
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8127207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG00736Medicare UPIN
NV30960Medicare ID - Type Unspecified