Healthcare Provider Details

I. General information

NPI: 1821484304
Provider Name (Legal Business Name): SEAN MCNAMARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 S MAIN ST
BRADFORD VT
05033-9196
US

IV. Provider business mailing address

437 S MAIN ST
BRADFORD VT
05033-9196
US

V. Phone/Fax

Practice location:
  • Phone: 802-222-9317
  • Fax: 888-462-0883
Mailing address:
  • Phone: 802-222-9317
  • Fax: 888-462-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10100721-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042.0017870
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: