Provider Demographics
NPI:1689979833
Name:MCNAMARA, BRETT PATRICK (OD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:PATRICK
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8484 DORCHESTER RD
Mailing Address - Street 2:STE C-1
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7319
Mailing Address - Country:US
Mailing Address - Phone:843-767-2328
Mailing Address - Fax:
Practice Address - Street 1:8484 DORCHESTER RD
Practice Address - Street 2:STE C-1
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7319
Practice Address - Country:US
Practice Address - Phone:843-767-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1604152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist