Provider Demographics
NPI:1366420879
Name:LUMINIS HEALTH IMAGING, INC.
Entity type:Organization
Organization Name:LUMINIS HEALTH IMAGING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-481-5335
Mailing Address - Street 1:PO BOX 404433
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-4433
Mailing Address - Country:US
Mailing Address - Phone:443-481-5330
Mailing Address - Fax:443-481-5882
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:443-481-5330
Practice Address - Fax:443-481-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8315136OtherAETNA PPO - ALL LOCATIONS
MDS645ANOtherCAREFIRST BCBS MARYLAND
146232903OtherDEPT OF LABOR - KENT ISL
MD60056008OtherBLUE CROSS MD - BRST CTR
MDCA1932OtherRR MEDICARE
DC1073OtherBLUE CROSS DC - ALL LOC
DCG01780OtherMEDICARE DC LOCAL
MD60056009OtherBLUE CROSS MD - SAJAK
MD60056003OtherBLUE CROSS MD - WEEMS
146232901OtherDEPT OF LABOR - NIGHTTIME
MD764801410Medicaid
MDCK5500OtherRR MEDICARE KENT ISLAND
MD60056010OtherBLUE CROSS MD - KENT ISL
MDCK4885OtherRR MEDICARE BOWIE
MDS645ANOtherBLUE CROSS OF MD ALL LOC
MD0067997OtherAETNA HMO - ALL OTHER
146232900OtherDEPT OF LABOR - SAJAK &BC
146232904OtherDEPT OF LABOR - WEEMS CRK
146232905OtherDEPT OF LABOR - WAUGH
MD216295OtherMAMSI - ALL LOCATIONS
MD60056007OtherBLUE CROSS MD - NIGHTTIME