# LUMINIS HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AAMG Annapolis OB-GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629577424
- **Authorized official:** PETER ODENWALD (REIMBURSEMENT ADMINISTRATOR)
- **Authorized official phone:** (443) 481-6415

## Contact information

- **Practice address:** 18 MAGOTHY BEACH ROAD SUITE A, PASADENA, MD 21122
- **Practice address phone:** (410) 573-9530
- **Mailing address:** 201 DEFENSE HIGHWAY SUITE 150, ANNAPOLIS, MD 21401

## Taxonomy

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

## Other

- **Enumeration date:** 02/07/2018
- **Last updated:** 05/24/2021