MEDICARE: LAUREN R MAHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	0101284315	VA
2	207V00000X	Obstetrics & Gynecology Physician	MD461843	PA
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1942643895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN R MAHER MD

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 HIGHLAND AVE SE STE 303
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24013-2253
Country	:	US
Telephone Number	:	540-985-9715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2013
Last Update Date	:	09/19/2025

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