Provider Demographics
NPI:1912092610
Name:MCNAMEE, STEPHEN MITCHELL (CP)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:MITCHELL
Last Name:MCNAMEE
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3339
Mailing Address - Country:US
Mailing Address - Phone:602-667-7827
Mailing Address - Fax:602-667-7826
Practice Address - Street 1:4501 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3339
Practice Address - Country:US
Practice Address - Phone:602-667-7827
Practice Address - Fax:602-667-7826
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3915220002Medicare NSC