# LUMINIS HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720304223
- **Authorized official:** PETER ODENWALD (VP BUSINESS DEVELOPMENT)
- **Authorized official phone:** (443) 481-6415

## Contact information

- **Practice address:** 4175 N HANSON CT STE 203, BOWIE, MD 20716-3183
- **Practice address phone:** (443) 481-1199
- **Practice address fax:** (443) 481-1495
- **Mailing address:** 2000 MEDICAL PKWY STE 409, ANNAPOLIS, MD 21401-3746
- **Mailing address phone:** (667) 204-7212
- **Mailing address fax:** (443) 481-4151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 2086X0206X | Surgical Oncology Physician | — | NULL | — |
| 2086X0206X | Surgical Oncology Physician | — | — | — |

## Other

- **Enumeration date:** 04/09/2010
- **Last updated:** 12/06/2024