# LOUDOUN MEDICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOUDOUN MEDICAL GROUP, PC
- **Other names:** NoVa Anesthesia Providers
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295427623
- **Legal business name:** LOUDOUN MEDICAL GROUP, PC
- **Authorized official:** MARY BETH TAMASY (CEO)
- **Authorized official phone:** (703) 737-6010

## Contact information

- **Practice address:** 4660 KENMORE AVENUE, SUITE 100, ALEXANDRIA, VA 22304-1306
- **Practice address phone:** (703) 751-5763
- **Mailing address:** 224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-1306
- **Mailing address phone:** (703) 737-6010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2023
- **Last updated:** 05/24/2023