Provider Demographics
NPI:1427019835
Name:MCNAMEE, SHANE D (MD)
Entity Type:Individual
Prefix:
First Name:SHANE
Middle Name:D
Last Name:MCNAMEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 N THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2718
Mailing Address - Country:US
Mailing Address - Phone:804-359-1337
Mailing Address - Fax:
Practice Address - Street 1:5000 COX RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-9263
Practice Address - Country:US
Practice Address - Phone:804-968-5700
Practice Address - Fax:804-217-7991
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237619208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI33447Medicare UPIN
VA007750P95 - C03895Medicare ID - Type Unspecified