Provider Demographics
NPI:1265727937
Name:MCNAMARA, ANDREW RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RYAN
Last Name:MCNAMARA
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 1:1431 PREMIER DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6076
Mailing Address - Country:US
Mailing Address - Phone:507-386-6600
Mailing Address - Fax:507-386-0252
Practice Address - Street 1:1431 PREMIER DR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001
Practice Address - Country:US
Practice Address - Phone:507-386-6600
Practice Address - Fax:507-386-0252
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN63358207XS0106X, 207X00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1265727937OtherMEDICA
MN1265727937OtherCORVEL
MN1265727937OtherPREFERRED ONE
MN1265727937OtherUCARE
MN1265727937OtherHEALTH PARTNERS
MN1265727937OtherMAYO CLINIC HEALTH SOLUTIONS
MN1265727937OtherBCBS OF MN
MN1265727937Medicaid
MN1265727937OtherPRIMEWEST