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Organization

LOUDOUN MEDICAL GROUP, PC

Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Clear Dermatology
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
22365 BRODERICK DRIVE, SUITE 115, STERLING, VA 20166-9362
(703) 996-4000
(571) 707-8123
Mailing address
224D CORNWALL STREET, NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
04/18/2018
Last updated
05/22/2023
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