Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 2901018436 | MI |
N | 213EG0000X | General Practice | 2901018436 | MI |
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2536 | OH |
NPI | 1366659658 |
---|---|
Provider Name | Dr. Kristin Kay Mcnamara |
First Address | Columbus, OH 43212-3570 |
Second Address | Columbus, OH 43210-1267 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 29/10/2014 |