Provider Demographics
NPI:1104881788
Name:NOGUEIRA, JOSEPH MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:NOGUEIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-5720
Mailing Address - Fax:410-328-5685
Practice Address - Street 1:7601 OSLER DR
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7700
Practice Address - Country:US
Practice Address - Phone:410-427-2574
Practice Address - Fax:410-427-2054
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046403208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810000278Medicaid
MD644975-01 & 02OtherBLUE CROSS/BLUE SHIELD
MD032200800Medicaid
DC036236400Medicaid
DE1000032314Medicaid
MDS015D852Medicare PIN
DC036236400Medicaid
G66891Medicare UPIN