# 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:** 1538645817
- **Authorized official:** JEANNETTE WOOD (REIMBURESMENT ADMINISTRATOR)
- **Authorized official phone:** (443) 481-6521

## Contact information

- **Practice address:** 1106 ANNAPOLIS RD STE 220, ODENTON, MD 21113-1740
- **Practice address phone:** (301) 352-4007
- **Practice address fax:** (301) 352-3316
- **Mailing address:** 201 DEFENSE HWY STE 150, ANNAPOLIS, MD 21401-8953
- **Mailing address phone:** (443) 481-5310
- **Mailing address fax:** (443) 481-6515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | MD | Yes |

## Other

- **Enumeration date:** 07/19/2018
- **Last updated:** 05/24/2021