Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Metropolitan Immune
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CEO)
(703) 737-6001
Entity
Organization
Contact information
Practice address
6355 WALKER LANE, SUITE 308, ALEXANDRIA, VA 22310-3247
(703) 313-7700
(703) 313-0178
Mailing address
224D CORNWALL STREET NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6001
(571) 291-9786
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
08/18/2023
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