Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Virginia Center for Neurosciences
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CREDENTIALING COORDINATOR)
(703) 737-6010
Entity
Organization
Contact information
Practice address
19450 DEERFIELD AVE, SUITE 175, LEESBURG, VA 20176-6820
(703) 858-5454
(703) 858-4650
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
08/18/2023
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