Provider Demographics
NPI:1740287291
Name:MCNAMEE, KENNETH JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:JOSEPH
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 1:211 HOLLYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2636
Mailing Address - Country:US
Mailing Address - Phone:734-243-9851
Mailing Address - Fax:734-243-2527
Practice Address - Street 1:214 E ELM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2600
Practice Address - Country:US
Practice Address - Phone:734-243-9851
Practice Address - Fax:734-243-2527
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2023-11-03
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
MIKM405342207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI967OtherHEALTH PLAN OF MICHIGAN
MIE85473OtherHEALTH ALLIANCE PLAN
MI1980954Medicaid
MI4087152OtherAETNA
MI1003074OtherCIGNA
MIP41114OtherBLUE CARE NETWORK
MIM017009OtherTRICARE
MI02150OtherPARAMOUNT
MI0581044OtherBCBS OF MICHIGAN
MI200005615OtherRAIL ROAD MEDICARE
MIE85473OtherHEALTH ALLIANCE PLAN
MI0581609Medicare ID - Type Unspecified