Provider Demographics
NPI:1033119524
Name:MCNAMARA, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:400 COLUMBUS AVENUE
Mailing Address - Street 2:CREDENTIALING SPECIALIST
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1233
Mailing Address - Country:US
Mailing Address - Phone:203-503-3174
Mailing Address - Fax:203-503-6515
Practice Address - Street 1:333 CEDAR ST
Practice Address - Street 2:FMP 3
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3206
Practice Address - Country:US
Practice Address - Phone:203-785-4127
Practice Address - Fax:203-785-7144
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2020-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT040324207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010040324CT03OtherBLUE CROSS BLUE SHIELD
CTP00211828OtherRAILROAD MEDICARE
CT3787096OtherAETNA
CT040324OtherCONNECTICARE
CTP00211828OtherRAILROAD MEDICARE
CT040324OtherCONNECTICARE