Provider Demographics
NPI:1831188135
Name:LAHREN, RODNEY HAROLD (MD)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:HAROLD
Last Name:LAHREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-0188
Mailing Address - Country:US
Mailing Address - Phone:207-408-1831
Mailing Address - Fax:
Practice Address - Street 1:193 MAIN ST STE 16
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5647
Practice Address - Country:US
Practice Address - Phone:207-743-2544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013931208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F94978Medicare UPIN
MM6513Medicare ID - Type Unspecified