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 (CEO)
(703) 737-6010
Entity
Organization
Contact information
Practice address
921 E. MAIN STREET, SUITE A, PURCELLVILLE, VA 20132-3133
(540) 338-6994
(540) 662-6903
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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