Healthcare Provider Details
I. General information
NPI: 1700705571
Provider Name (Legal Business Name): LUMINIS HEALTH MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
134 HOLIDAY CT STE 300
ANNAPOLIS MD
21401-7008
US
IV. Provider business mailing address
2000 MEDICAL PKWY STE 409
ANNAPOLIS MD
21401-3746
US
V. Phone/Fax
- Phone: 443-481-6699
- Fax: 443-481-6713
- Phone: 443-481-4150
- Fax: 443-481-4151
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELISSA
RAPATTONI
Title or Position: AO
Credential:
Phone: 443-481-5136