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Individual

DR. CHARLES W RUGGLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19699
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01196997
CO
01
04-15064
KANSAS LICENSE
KS
01
06D0517138
CLIA
CO
05
100127700A
KS
01
19677
COLORADO LICENSE
CO
Enumeration date
02/07/2006
Last updated
02/18/2016
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