Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Advanced ENT Specialists
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
19490 SANDRIDGE WAY, SUITE 70, LEESBURG, VA 20176-3472
(703) 858-5885
(703) 858-5001
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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