Individual
MARK HAROLD PASSARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 RIVERBEND DR, CHARLOTTESVILLE, VA 22911-8607
(434) 295-0184
(434) 295-2463
Mailing address
155 RIVERBEND DR, CHARLOTTESVILLE, VA 22911-8607
(434) 295-0184
(434) 295-2463
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101234456
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
386744
ANTHEM/BLUE CROSS
—
Enumeration date
01/11/2006
Last updated
04/14/2021
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