=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578441267
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUMINIS HEALTH MEDICAL GROUP, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2025
-----------------------------------------------------
Last Update Date | 08/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14090 HG TRUEMAN RD STE 1100
-----------------------------------------------------
City | SOLOMONS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20688-3151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-414-4740
-----------------------------------------------------
Fax | 410-414-4741
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2002 MEDICAL PKWY STE 409
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21401-3046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-481-1000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AO
-----------------------------------------------------
Name | MELISSA RAPATTONI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 443-481-5136
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------