Provider Demographics
NPI:1114065026
Name:MCNAMARA, JOHN PATRICK (MS, DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 W CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-3836
Mailing Address - Country:US
Mailing Address - Phone:540-389-7051
Mailing Address - Fax:540-389-2050
Practice Address - Street 1:27 W CALHOUN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3836
Practice Address - Country:US
Practice Address - Phone:540-389-7051
Practice Address - Fax:540-389-2050
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001257111N00000X
PADC005534L111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA240716OtherANTHEM BCBS
VAT01619Medicare UPIN