# LUMINIS HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Annapolis Thoracic Surgery Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295063923
- **Authorized official:** STEPHEN CLARKE (VICE PRESIDENT)
- **Authorized official phone:** (443) 481-6476

## Contact information

- **Practice address:** 1630 MAIN ST, SUITE 213, CHESTER, MD 21619-2791
- **Practice address phone:** (443) 481-3300
- **Practice address fax:** (443) 481-3315
- **Mailing address:** PO BOX 412752, BOSTON, MA 02241-4017
- **Mailing address phone:** (443) 481-6538
- **Mailing address fax:** (443) 481-6515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/18/2009
- **Last updated:** 02/22/2023