# LUMINIS HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306197132
- **Authorized official:** JEANNETTE WOOD (EXEC. DIR. PHYSICIAN REIMBURSEMENT)
- **Authorized official phone:** (443) 481-6476

## Contact information

- **Practice address:** 2000 MEDICAL PKWY STE 309, ANNAPOLIS, MD 21401-3745
- **Practice address phone:** (301) 352-4007
- **Mailing address:** PO BOX 12622, BELFAST, ME 04915-4017
- **Mailing address phone:** (443) 481-6467
- **Mailing address fax:** (443) 481-6515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/19/2012
- **Last updated:** 05/24/2021