Healthcare Provider Details

I. General information

NPI: 1457330961
Provider Name (Legal Business Name): MICHAEL G MCNAMARA M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 LAKE OTIS PKWY STE 100
ANCHORAGE AK
99508-5235
US

IV. Provider business mailing address

3930 N POINT DR
ANCHORAGE AK
99502-1451
US

V. Phone/Fax

Practice location:
  • Phone: 907-802-6803
  • Fax: 907-802-6808
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number3448
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number3448
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: