Healthcare Provider Details

I. General information

NPI: 1316940141
Provider Name (Legal Business Name): MAUREEN D PASSARO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAUREEN DONNELLY M.D.

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18109 PRINCE PHILIP DR STE B
OLNEY MD
20832-1519
US

IV. Provider business mailing address

2901 OLNEY SANDY SPRING RD
OLNEY MD
20832-1521
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-4529
  • Fax: 301-774-5652
Mailing address:
  • Phone: 301-774-6655
  • Fax: 301-774-5652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0044487
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: