Healthcare Provider Details

I. General information

NPI: 1790743144
Provider Name (Legal Business Name): AMANDA E RUGGLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA E DUPREEZ MD

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PARK ST
MADISON WI
53715-1830
US

IV. Provider business mailing address

700 S PARK ST
MADISON WI
53715-1830
US

V. Phone/Fax

Practice location:
  • Phone: 608-251-6100
  • Fax: 608-258-6259
Mailing address:
  • Phone: 608-251-6100
  • Fax: 608-258-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number9461479
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49782-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number49782-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: