Organization
LOUDOUN MEDICAL GROUP, PC
Active
Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Michael Kavanagh, MD
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
224 D CORNWALL STREET, NW, SUITE 204, LEESBURG, VA 20176-2700
(703) 777-3262
(703) 777-3365
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG8678
RR MEDICARE GROUP PIN
VA
Enumeration date
01/16/2008
Last updated
09/20/2022
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