Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 22502 | SC |
NPI | 1093777393 |
---|---|
Provider Name | Dr. Jeffrey Michael Ruggieri |
First Address | Greenville, SC 29605-5611 |
Second Address | Greenville, SC 29605-5611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 12/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
225027 | (05) | SC |
296928742A | (05) | GA |