| Luminis Health Medical Group, Llc | |
|
1630 Main St Chester MD 21619-2791 | |
| (443) 481-1940 | |
| (443) 481-1941 |
| Full Name | Luminis Health Medical Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 1630 Main St, Chester, Maryland |
| Authorized Official Name and Position | Stephen Clarke (VICE PRESIDENT) |
| Authorized Official Contact | 4434816476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminis Health Medical Group, Llc Po Box 12622 Belfast ME 04915-4017 Ph: (443) 481-6467 | Luminis Health Medical Group, Llc 1630 Main St Chester MD 21619-2791 Ph: (443) 481-1940 |
| NPI Number | 1073902888 |
|---|---|
| Provider Enumeration Date | 01/16/2015 |
| Last Update Date | 05/21/2021 |
| Certification Date | 05/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073902888 | NPI | - | NPPES |
| 124015300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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