# LOUDOUN MEDICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOUDOUN MEDICAL GROUP, PC
- **Other names:** LMG Imaging Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710583919
- **Legal business name:** LOUDOUN MEDICAL GROUP, PC
- **Authorized official:** MARY BETH TAMASY (CEO)
- **Authorized official phone:** (703) 737-6010

## Contact information

- **Practice address:** 19500 SANDRIDGE WAY, SUITE 420, LANSDOWNE, VA 20176-3467
- **Practice address phone:** (571) 375-8601
- **Practice address fax:** (571) 223-6773
- **Mailing address:** 224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
- **Mailing address phone:** (703) 737-6010
- **Mailing address fax:** (571) 291-9786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/11/2020
- **Last updated:** 04/24/2023