Provider Demographics
NPI:1396637484
Name:PASSOS, MARIANA BALTHAZAR NOGUEIRA (MD)
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:BALTHAZAR NOGUEIRA
Last Name:PASSOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIANA
Other - Middle Name:BALTHAZAR
Other - Last Name:NOGUEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6607 LONE OAK DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1649
Mailing Address - Country:US
Mailing Address - Phone:202-604-1153
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:888-884-2327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMTL600211595207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine