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NPI Code Detail

MEDICARE: LUMINIS HEALTH MEDICAL GROUP, LLC

MEDICARE: LUMINIS HEALTH MEDICAL GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
127VGBAOTHERBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
36832OTHERBCBS

General Provider Information

NPI Number : 1396821435
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUMINIS HEALTH MEDICAL GROUP, LLC
Provider Business Mailing Address
First Line : PO BOX 12622
Second Line :
City : BELFAST
State : ME
Zip : 04915-4017
Country : US
Telephone Number : 443-481-6524
Fax Number : 443-481-6515
Provider Business Practice Location Address
First Line : 2003 MEDICAL PKWY STE G50
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-3067
Country : US
Telephone Number : 410-573-1094
Fax Number : 410-573-1097
Authorized Official
Title or Position : AO
Name : MELISSA RAPATTONI
Credential :
Telephone Number : 443-481-5136
Provider Enumeration Date : 10/31/2006
Last Update Date : 11/05/2024

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Directions to “LUMINIS HEALTH MEDICAL GROUP, LLC ” Practice Location

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