Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
Surgical Specialists at AAMC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN CLARKE (VICE PRESIDENT)
(443) 481-6476
Entity
Organization
Contact information
Practice address
2000 MEDICAL PKWY, SUITE 600, ANNAPOLIS, MD 21401-3742
(443) 481-6699
(443) 481-6713
Mailing address
PO BOX 62740, BALTIMORE, MD 21264-2740
(443) 481-6538
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D02390
MD
Other
Enumeration date
10/10/2012
Last updated
05/24/2021
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