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Organization

LOUDOUN MEDICAL GROUP, PC

Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Loudoun Medical Group, PC 'D'
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
6355 WALKER LANE, SUITE 308, ALEXANDRIA, VA 22310-3247
(703) 737-6010
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
12/22/2022
Last updated
08/18/2023
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