Organization
LOUDOUN MEDICAL GROUP, PC
Active
Organization
LOUDOUN MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH TAMASY (CEO)
(703) 737-6010
Entity
Organization
Contact information
Practice address
224D CORNWALL ST NW, SUITE 403, LEESBURG, VA 20176-2700
(703) 737-6010
(703) 443-8643
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RI0200X
Infectious Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VG0400X
Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG8678
RR MEDICARE GROUP
VA
01
—
CG8679
RRMEDICARE
DC
01
—
CG8680
RR MEDICARE DC
DC
01
—
EC2891
RR MEDICARE PTAN 2023
VA
Enumeration date
07/18/2006
Last updated
08/18/2023
Update your record
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