Organization
LUMINIS HEALTH MEDICAL GROUP, LLC
Active
Other names
Centreville Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA RAPATTONI (AO)
(443) 481-5136
Entity
Organization
Contact information
Practice address
202 COURSEVALL DR STE 101, CENTREVILLE, MD 21617-2805
(410) 758-3303
(410) 758-3310
Mailing address
2001 MEDICAL PKWY STE 409, ANNAPOLIS, MD 21401-3773
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D35048
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407175117
—
MD
Enumeration date
07/03/2008
Last updated
10/17/2024
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