Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Martin A. Korkowski, MD, Mancini and Korkowski
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CEO)
(703) 737-6001
Entity
Organization
Contact information
Practice address
44055 RIVERSIDE PKWY STE 216, LEESBURG, VA 20176-5176
(703) 858-1395
(703) 858-7468
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6001
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG8678
RR MEDICARE PIN
VA
01
—
CG8680
RR MEDICARE PIN
DC
Enumeration date
03/15/2007
Last updated
08/18/2023
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