# LOUDOUN MEDICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOUDOUN MEDICAL GROUP, PC
- **Other names:** Physicians Premiere Weight and Wellness Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962369959
- **Legal business name:** LOUDOUN MEDICAL GROUP, PC
- **Authorized official:** MARY BETH TAMASY (CEO)
- **Authorized official phone:** (703) 737-6010

## Contact information

- **Practice address:** 3700 JOSEPH SIEWICK DRIVE, SUITE 106, FAIRFAX, VA 22033-1737
- **Practice address phone:** (571) 724-4400
- **Mailing address:** 224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
- **Mailing address phone:** (703) 737-6010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2026
- **Last updated:** 01/28/2026