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Contact Information

LUMINIS HEALTH MEDICAL GROUP, LLC
4175 N HANSON CT
SUITE 201
BOWIE, MD20716-3179
 Phone: 443-481-3713
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Oncology

2086X0206X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for LUMINIS HEALTH MEDICAL GROUP, LLC

NPI Number 1851710552
LBN Legal business name LUMINIS HEALTH MEDICAL GROUP, LLC
Authorized official PETER ODENWALD - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/09/2014
Last updated 05/24/2021 - About 5 years ago
Identifiers
MD License # D68660
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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