Healthcare Provider Details

I. General information

NPI: 1104881788
Provider Name (Legal Business Name): JOSEPH MICHAEL NOGUEIRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 OSLER DR
TOWSON MD
21204-7700
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 410-427-2574
  • Fax: 410-427-2054
Mailing address:
  • Phone: 410-328-5720
  • Fax: 410-328-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0046403
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: