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Organization
LOUDOUN MEDICAL GROUP, PC
Active
Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Loudoun Medical Group, PC DME
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CEO)
(703) 737-6010
Entity
Organization
Contact information
Practice address
224-D CORNWALL ST, NW, SUITE 204, LEESBURG, VA 20176-2700
(703) 737-6000
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
NULL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/18/2023
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