Healthcare Provider Details

I. General information

NPI: 1861011488
Provider Name (Legal Business Name): LAUREN MARIE MCALLISTER RADFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 CIVIC CENTER DR
AUGUSTA ME
04330-8572
US

IV. Provider business mailing address

442 CIVIC CENTER DR
AUGUSTA ME
04330-8572
US

V. Phone/Fax

Practice location:
  • Phone: 207-621-9550
  • Fax: 207-621-9551
Mailing address:
  • Phone: 207-621-9550
  • Fax: 207-621-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberMD29607
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: