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Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
Eastern Shore Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ODENWALD (VICE PRESIDENT)
(443) 481-6415
Entity
Organization
Contact information
Practice address
1630 MAIN ST, CHESTER, MD 21619-2791
(410) 643-4524
(410) 643-4523
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6576
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/02/2012
Last updated
05/24/2021
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