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Organization

LOUDOUN MEDICAL GROUP, PC

Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Skin Cancer Center of Northern Virginia
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
19500 SANDRIDGE WAY STE 400, LEESBURG, VA 20176-3691
(703) 723-5700
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6000

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1675951440
VA
Enumeration date
05/29/2020
Last updated
08/18/2023
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