Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
Annapolis Surgical Oncology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ODENWALD (VICE PRESIDENT)
(443) 481-6415
Entity
Organization
Contact information
Practice address
4175 N HANSON CT, SUITE 201, BOWIE, MD 20716-3179
(443) 481-3713
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6538
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
D68660
MD
Other
Enumeration date
04/09/2014
Last updated
05/24/2021
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