MEDICARE: DR. PETER W RUGG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	51823	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J0267701	OTHER	MA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508856121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER W RUGG MD

Provider Business Mailing Address
First Line	:	5 SHREWSBURY ST STE D
Second Line	:
City	:	HOLDEN
State	:	MA
Zip	:	01520-1960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 SHREWSBURY ST STE D
Second Line	:
City	:	HOLDEN
State	:	MA
Zip	:	01520
Country	:	US
Telephone Number	:	508-829-3800
Fax Number	:	508-829-3802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	02/06/2023

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Directions to “ DR. PETER W RUGG MD” Practice Location

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