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NPI Code Detail

MEDICARE: LUX MEDICA LLC

MEDICARE: LUX MEDICA 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
1208800000XUrology Physician

General Provider Information

NPI Number : 1942192810
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUX MEDICA LLC
Provider Business Mailing Address
First Line : 314 CEDAR LN
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-3909
Country : US
Telephone Number : 443-454-1761
Fax Number : 712-208-8175
Provider Business Practice Location Address
First Line : 1447 YORK RD STE 406
Second Line :
City : LUTHERVILLE
State : MD
Zip : 21093-6057
Country : US
Telephone Number : 410-343-3001
Fax Number : 410-823-0015
Authorized Official
Title or Position : CERTIFIED PHYSICIAN ASSISTANT
Name : MR. WARREN CLIFTON MCCORMICK
Credential : PA-C
Telephone Number : 443-454-1761
Provider Enumeration Date : 07/16/2025
Last Update Date : 07/16/2025

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Directions to “LUX MEDICA LLC ” Practice Location

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