Healthcare Provider Details

I. General information

NPI: 1417042805
Provider Name (Legal Business Name): TERRENCE R MCNAMARA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 OLD STREET RD SUITE 200
PETERBOROUGH NH
03458-1265
US

IV. Provider business mailing address

458 OLD STREET RD SUITE 200
PETERBOROUGH NH
03458-1265
US

V. Phone/Fax

Practice location:
  • Phone: 603-924-2144
  • Fax:
Mailing address:
  • Phone: 603-924-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number102519
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number14887
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: