Organization
LOUDOUN MEDICAL GROUP, PC
Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
MATTHEW B GAVIN
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOUDOUN MEDICAL GROUP, PC
Authorized official
MARY BETH TAMASY (CEO)
(703) 737-6012
Entity
Organization
Contact information
Practice address
24430 STONE SPRINGS BLVD, SUITE 100, DULLES, VA 20166-2247
(703) 777-3262
(703) 777-3365
Mailing address
224D CORNWALL ST NW, SUITE 403, LEESBURG, VA 20176-2700
(703) 737-6012
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
08/18/2023
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