Organization
LOUDOUN MEDICAL GROUP, PC
Active
Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Digestive Disease Physicians
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
4660 KENMORE AVE STE 500, ALEXANDRIA, VA 22304-1300
(703) 757-5763
(703) 370-8704
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(571) 291-9786
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1675951440
—
VA
Enumeration date
07/20/2020
Last updated
09/16/2022
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