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Organization

LOUDOUN MEDICAL GROUP, PC

Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Loudoun Medical Group, PC DOL
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
8988 LORTON STATION BLVD, SUITE 202, LORTON, VA 22079-4758
(703) 372-2280
Mailing address
224-D CORNWALL STREET NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
11/13/2023
Last updated
11/13/2023
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