Provider Demographics
NPI:1841414679
Name:PASSERO, KEVIN (ND)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:PASSERO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LUBRANO DR STE L15
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7163
Mailing Address - Country:US
Mailing Address - Phone:443-433-5540
Mailing Address - Fax:
Practice Address - Street 1:1330 NEW HAMPSHIRE AVE NW
Practice Address - Street 2:SUITE B4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6350
Practice Address - Country:US
Practice Address - Phone:503-704-3242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1295175F00000X
DCNP-0018175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath