# MR. DOUGLAS C DIRUGGIERO JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1730145327
- **Gender:** Man
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 003061 | GA | Yes |

## Other

- **Enumeration date:** 04/24/2006
- **Last updated:** 11/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 534385262C | — | GA |
| 05 | — | 534385262L | — | GA |