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Organization

LOUDOUN MEDICAL GROUP, PC

Active
Parent organization
LOUDOUN MEDICAL GROUP, PC
Other names
Loudoun Medical Group, PC 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
224-D CORNWALL ST, NW, SUITE 204, LEESBURG, VA 20176-2700
(703) 737-6000
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary

Other

Enumeration date
08/28/2020
Last updated
08/18/2023
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