Provider Demographics
NPI:1043888480
Name:MCNAMARA, NATALYA (MD)
Entity type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:MCNAMARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATALYA
Other - Middle Name:
Other - Last Name:POLUKOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:803 E WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3217
Mailing Address - Country:US
Mailing Address - Phone:435-640-0345
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR DEPT OF
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-13
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program