Organization
LOUDOUN ENT & ALLERGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMEET MATHUR MD (PRESIDENT)
(703) 858-0303
Entity
Organization
Contact information
Practice address
19455 DEERFIELD AVE, SUITE 312, LANSDOWNE, VA 20176-8446
(703) 858-0303
Mailing address
19455 DEERFIELD AVE, SUITE 312, LANSDOWNE, VA 20176-8446
(703) 858-0303
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
0101238286
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609864115
NPI
VA
Enumeration date
06/16/2006
Last updated
08/22/2020
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