Provider Demographics
NPI:1962848358
Name:MACNAMARA, MARINA MEGHAN CAITLIN (MD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:MEGHAN CAITLIN
Last Name:MACNAMARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 WESTRIDGE MARKET PL
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-9174
Mailing Address - Country:US
Mailing Address - Phone:828-418-0040
Mailing Address - Fax:828-418-0041
Practice Address - Street 1:25 WESTRIDGE MARKET PL
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-9174
Practice Address - Country:US
Practice Address - Phone:828-418-0040
Practice Address - Fax:828-418-0041
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-00558207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCT574A194Medicare PIN
NCNCT574DMedicare PIN
NCNCT574AMedicare PIN
NCNCT574F135Medicare PIN
NCNCT574CMedicare PIN
NCNCT574BMedicare PIN