Provider Demographics
NPI:1073615852
Name:RUTIGLIANO, MARIAN C (DO)
Entity type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:C
Last Name:RUTIGLIANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PENNSYLVANIA AVE NW
Mailing Address - Street 2:MAIL CODE: 8601P
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20460-0001
Mailing Address - Country:US
Mailing Address - Phone:703-347-0186
Mailing Address - Fax:
Practice Address - Street 1:1200 PENNSYLVANIA AVE NW
Practice Address - Street 2:MAIL CODE: 8601P
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20460-0001
Practice Address - Country:US
Practice Address - Phone:703-347-0186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0044296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD498651200Medicaid
MD498651200Medicaid