Provider Demographics
NPI:1932190253
Name:MCNAMARA, THOMAS W (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:MCNAMARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S ELLISON LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-2122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:428 S MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3629
Practice Address - Country:US
Practice Address - Phone:540-949-8241
Practice Address - Fax:540-949-5582
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102-037072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005624002Medicaid
VA018063C18Medicare PIN
080005702Medicare ID - Type Unspecified
VA005624002Medicaid