Basic Information
| Provider Information | |||||||||
| NPI: | 1043263379 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCNAMARA | ||||||||
| FirstName: | GREGORY | ||||||||
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| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1807 | ||||||||
| Address2: | |||||||||
| City: | MERRIMACK | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030541807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036739411 | ||||||||
| FaxNumber: | 6036739899 | ||||||||
| Practice Location | |||||||||
| Address1: | 33 BARTLETT ST | ||||||||
| Address2: | |||||||||
| City: | LOWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018521334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784527233 | ||||||||
| FaxNumber: | 9784586430 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 10/31/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 1639 | MA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213E00000X | 0151 | NH | N | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 701125 | 01 | MA | TUFTS HEALTH PLAN | OTHER | Y70726 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 1524676 | 01 | UNITED MINE WORKERS | OTHER | 98215702 | 01 | MA | NETWORK HEALTH | OTHER | 0006112 | 01 | MA | NEIGHBORHOOD HEALTH | OTHER | 480022699 | 01 | MA | RAILROAD MEDICARE | OTHER | 86560 | 01 | HEALTHSOURCE | OTHER | 0307130Y0NH01 | 01 | NH | ANTHEM BLUE CROSS | OTHER | 33217 | 01 | HARVARD PILGRIM | OTHER | 80003645 | 05 | NH | MEDICAID | 042779503 | 01 | CIGNA | OTHER | 20536 | 01 | FALLON COMMUNITY HEALTH | OTHER | 2700058 | 01 | UNITED HEALTHCARE | OTHER |