Healthcare Provider Details
I. General information
NPI: 1720043797
Provider Name (Legal Business Name): PAUL M RUGGIERI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/20/2006
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9500 EUCLID AVE
CLEVELAND OH
44195-0001
US
IV. Provider business mailing address
6000 W CREEK RD SUITE 10
INDEPENDENCE OH
44131-2139
US
V. Phone/Fax
- Phone: 800-223-2273
- Fax:
- Phone: 800-223-2273
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 221983-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085D0003X |
| Taxonomy | Diagnostic Neuroimaging (Radiology) Physician |
| License Number | 221983-1 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 35055153 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: