Individual
PATRICK R MCNAMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 519-1604
(401) 272-0538
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00564
RI
363A00000X
Physician Assistant
PA3840
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001316901
RI MEDICARE
RI
01
—
12-01-2010
UNITED HEALTHCARE
RI
01
—
12-09-2010
NHPRI
RI
01
—
939025129
RI MEDICARE GROUP
RI
05
—
PM82935
—
RI
Enumeration date
09/01/2009
Last updated
08/30/2011
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