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General NPI Number Information
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NPI Number | 1851677181
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Entity Type | Organization
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Legal Business Name | LUMINIS HEALTH MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 4175 N HANSON CT STE 209
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City | BOWIE
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State | MD
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Zip | 20716-3184
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Country | US
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Telephone | 443-481-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 412752
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City | BOSTON
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State | MA
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Zip | 02241-2752
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Country | US
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Telephone | 443-481-6467
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Fax | 443-481-6515
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Authorized Official
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Title or Position | AO
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Name | ANTWINA STEGER
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Credential |
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Telephone | 667-204-7051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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