Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Matthew B Gavin MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
JAMES A LAPSLEY (CEO)
(703) 737-6010
Entity
Organization
Contact information
Practice address
19 FORT EVANS RD NE STE C, LEESBURG, VA 20176-4487
(703) 777-3262
(703) 777-3365
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 777-3262
(703) 777-3365
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG8678
RR MEDICARE PIN
VA
Enumeration date
03/19/2007
Last updated
08/18/2023
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