Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
DME
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CREDENTIALING MANAGER)
(703) 737-6001
Entity
Organization
Contact information
Practice address
7430 HERITAGE VILLAGE PLZ UNIT 101, GAINESVILLE, VA 20155-3089
(703) 753-3338
(703) 753-7870
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6000
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
08/18/2020
Last updated
06/08/2023
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