Provider Demographics
NPI:1952665028
Name:MACNAMARA, DURAN L (PA-C)
Entity Type:Individual
Prefix:
First Name:DURAN
Middle Name:L
Last Name:MACNAMARA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DURAN
Other - Middle Name:L
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:955 BELLEFONTE AVE
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-3033
Practice Address - Country:US
Practice Address - Phone:570-748-7714
Practice Address - Fax:570-893-6325
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055598363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical