# LOUDOUN MEDICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOUDOUN MEDICAL GROUP, PC
- **Other names:** Metropolitan Immune
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275124356
- **Legal business name:** LOUDOUN MEDICAL GROUP, PC
- **Authorized official:** MARY BETH TAMASY (CEO)
- **Authorized official phone:** (703) 737-6001

## Contact information

- **Practice address:** 8260 GREENSBORO DR SUITE A-30, MCLEAN, VA 22102-4935
- **Practice address phone:** (703) 884-8494
- **Practice address fax:** (703) 313-6718
- **Mailing address:** 224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
- **Mailing address phone:** (703) 737-6001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207KI0005X | Clinical & Laboratory Immunology (Allergy & Immunology) Physician | — | NULL | Yes |
| 207KI0005X | Clinical & Laboratory Immunology (Allergy & Immunology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2021
- **Last updated:** 12/01/2023