Provider Demographics
NPI:1043263379
Name:MCNAMARA, GREGORY (DPM)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1807
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-1807
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:33 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1334
Practice Address - Country:US
Practice Address - Phone:978-452-7233
Practice Address - Fax:978-458-6430
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1639213E00000X
NH0151213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA701125OtherTUFTS HEALTH PLAN
MAY70726OtherBLUE CROSS BLUE SHIELD
1524676OtherUNITED MINE WORKERS
MA98215702OtherNETWORK HEALTH
MA0006112OtherNEIGHBORHOOD HEALTH
MA480022699OtherRAILROAD MEDICARE
86560OtherHEALTHSOURCE
NH0307130Y0NH01OtherANTHEM BLUE CROSS
33217OtherHARVARD PILGRIM
NH80003645Medicaid
042779503OtherCIGNA
20536OtherFALLON COMMUNITY HEALTH
2700058OtherUNITED HEALTHCARE
1524676OtherUNITED MINE WORKERS
NHRE3645Medicare PIN
MA98215702OtherNETWORK HEALTH