Individual
BRIAN JAMES RUGGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4212 GRAND AVE, DULUTH, MN 55807-2737
(218) 786-3500
Mailing address
400 E 3RD ST, DULUTH, MN 55805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
04-38413
KS
207Q00000X
Family Medicine Physician
Primary
56703
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002326
MEDICARE PTAN
KS
05
—
1437419603
—
MN
05
—
201120340A
—
KS
01
—
P01224928
RR MEDICARE
—
Enumeration date
05/22/2012
Last updated
08/03/2020
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