Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
Premier Ob/Gyn
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE WOOD (REIMBURSEMENT ADMINISTRATOR)
(443) 481-6521
Entity
Organization
Contact information
Practice address
4175 N HANSON CT, BOWIE, MD 20716
(301) 352-4007
(301) 352-3316
Mailing address
201 DEFENSE HWY STE 150, ANNAPOLIS, MD 21401-8953
(144) 348-1531
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y88800
CAREFIRST
MD
Enumeration date
07/19/2018
Last updated
05/24/2021
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