Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Parent organization
ANNE ARUNDEL PHYSICIAN GROUP LLC
Other names
SOUTH RIVER FAMILY MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANNE ARUNDEL PHYSICIAN GROUP LLC
Authorized official
MELISSA RAPATTONI (AO)
(443) 481-5136
Entity
Organization
Contact information
Practice address
3169 BRAVERTON ST, SUITE 201, EDGEWATER, MD 21037-2679
(410) 956-4911
(410) 956-4935
Mailing address
2000 MEDICAL PKWY STE 409, ANNAPOLIS, MD 21401-3746
(443) 481-5136
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407175107
—
MD
01
—
955BSO
BCBS
—
01
—
K643
BCBS
—
Enumeration date
03/07/2006
Last updated
11/05/2024
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