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Contact Information

LUMINIS HEALTH MEDICAL GROUP, LLC
2401 BRANDERMILL BLVD
SUITE 200
GAMBRILLS, MD21054-1690
 Phone: 410-451-0076
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for LUMINIS HEALTH MEDICAL GROUP, LLC

NPI Number 1508995697
LBN Legal business name LUMINIS HEALTH MEDICAL GROUP, LLC
Authorized official STEPHEN CLARKE - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/05/2007
Last updated 05/24/2021 - About 5 years ago
Identifiers
MD Medicaid 407175111
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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