Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
AAMG Diabetes & Endocrine Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ODENWALD (VICE PRESIDENT)
(443) 481-6415
Entity
Organization
Contact information
Practice address
1450 MERCANTILE LN, SUITE 111, LARGO, MD 20774-5376
(301) 925-7610
(301) 925-7619
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6476
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D02332
MD
Other
Enumeration date
10/19/2016
Last updated
05/24/2021
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