Provider Demographics
NPI:1760640056
Name:LOURENS, RAINA M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAINA
Middle Name:M
Last Name:LOURENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:35 MEDICAL CENTER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8160
Mailing Address - Country:US
Mailing Address - Phone:207-622-1959
Mailing Address - Fax:207-430-4007
Practice Address - Street 1:35 MEDICAL CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8160
Practice Address - Country:US
Practice Address - Phone:207-622-1959
Practice Address - Fax:207-430-4007
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD19162207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology