Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
The Breast Center
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA RAPATTONI (AO)
(443) 481-5136
Entity
Organization
Contact information
Practice address
1630 MAIN ST STE 112, CHESTER, MD 21619-2792
(443) 481-5300
(443) 481-6705
Mailing address
PO BOX 12622, BELFAST, ME 04915-4017
(443) 481-6573
(443) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407175131
—
MD
01
—
CRV6BR
BCBS
MD
01
—
V874
BCBS
DC
Enumeration date
05/06/2010
Last updated
10/15/2024
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