Healthcare Provider Details

I. General information

NPI: 1912348640
Provider Name (Legal Business Name): CONNOR M MCNAMARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE DEPT OF
CLEVELAND OH
44106
US

IV. Provider business mailing address

11100 EUCLID AVE DEPT OF
CLEVELAND OH
44106-1716
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-7334
  • Fax:
Mailing address:
  • Phone: 216-844-7334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35.131306
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number35.131306
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: