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Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ODENWALD (VP BUSINESS DEVELOPMENT)
(443) 481-6415
Entity
Organization
Contact information
Practice address
4175 N HANSON CT STE 203, BOWIE, MD 20716-3183
(443) 481-1199
(443) 481-1495
Mailing address
2000 MEDICAL PKWY STE 409, ANNAPOLIS, MD 21401-3746
(667) 204-7212
(443) 481-4151
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
2086X0206X
Surgical Oncology Physician
—
NULL
2086X0206X
Surgical Oncology Physician
—
—
Other
Enumeration date
04/09/2010
Last updated
12/06/2024
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