Organization
LOUDOUN MEDICAL GROUP, PC
Active
Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Michael A Kavanagh MD, Loudoun Spine & Rehabilitation
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
224D CORNWALL STREET, NW, SUITE 300, LEESBURG, VA 20176-2704
(703) 443-8110
(034) 432-7147
Mailing address
224-D CORNWALL STREET, NW., SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG8678
RR MEDICARE PIN
VA
Enumeration date
03/19/2007
Last updated
03/19/2026
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