Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
The Urology Group
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
1860 TOWN CENTER DRIVE, SUITE 150, RESTON, VA 20190-5905
(703) 480-0230
(703) 480-0280
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 480-0280
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG8680
RR MEDICARE
DC
Enumeration date
03/19/2007
Last updated
04/24/2023
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