Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
Anne Arundel Microvascular Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN L CLARKE (VP)
(443) 481-6464
Entity
Organization
Contact information
Practice address
2000 MEDICAL PKWY, SUITE 200, ANNAPOLIS, MD 21401-3742
(443) 481-3400
(443) 481-3315
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6573
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407175132
—
MD
01
—
CDD6AN
BCBS
MD
01
—
Y362
BCBS
DC
Enumeration date
07/06/2011
Last updated
05/24/2021
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