Provider Demographics
NPI:1841551140
Name:ANDRADE, LAUREN M (MD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:M
Other - Last Name:COLETTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:71 US ROUTE 1 STE C
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7174
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:71 US ROUTE 1 STE C
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7174
Practice Address - Country:US
Practice Address - Phone:207-883-5532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT218352207RA0002X
UT9740714-12052080P0202X
MEMD24495207RA0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart Disease
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology