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General NPI Number Information
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NPI Number | 1922635531
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Entity Type | Organization
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Legal Business Name | LUMIRI SURGICAL LLC
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 08/09/2020
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Provider Practice Location Address
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Address Line | 8116 GOOD LUCK RD STE 215
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City | LANHAM
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State | MD
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Zip | 20706-3508
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Country | US
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Telephone | 240-241-0420
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Fax | 862-298-0732
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Provider Business Mailing Address
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Address Line | 10325 KENSINGTON PKWY UNIT 432
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City | KENSINGTON
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State | MD
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Zip | 20895-7519
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Country | US
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Telephone | 240-241-0420
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Fax | 862-298-0732
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Authorized Official
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Title or Position | MANAGER
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Name | DR. TIFFANY ANN PIERCE SCHATZ
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Credential | MD
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Telephone | 240-241-0420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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