# LUMINIS HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AAMC Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477862308
- **Authorized official:** STEPHEN L CLARKE (VICE PRESIDENT- PHYSICIAN SERVICES)
- **Authorized official phone:** (443) 481-6464

## Contact information

- **Practice address:** 1419 FOREST DR, ANNAPOLIS, MD 21403-1482
- **Practice address phone:** (410) 990-0050
- **Practice address fax:** (410) 990-0336
- **Mailing address:** PO BOX 62551, BALTIMORE, MD 21264-2551
- **Mailing address phone:** (443) 481-6572
- **Mailing address fax:** (443) 481-6515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/27/2010
- **Last updated:** 05/24/2021