Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Loudoun Medical Group, DOL
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CEO)
(571) 707-2048
Entity
Organization
Contact information
Practice address
24430 STONE SPRINGS BLVD STE 215, DULLES, VA 20166-2268
(703) 858-3200
(703) 858-3203
Mailing address
224-D CORNWALL ST., NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6001
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/01/2021
Last updated
09/05/2023
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