Loudoun Medical Group, PC
Internal Medicine in Leesburg, VA. Organization (NPI-2).
NPI number1083001663
StatusActive
Last updated in NPPESApr 24, 2023
Details
- NPI
- 1083001663
- Entity type
- Organization (NPI-2)
- Legal business name
- Loudoun Medical Group, PC
- Organization subpart
- Yes
- Enumeration date
- Apr 21, 2015
- Certification date
- Apr 24, 2023
- Last updated
- Apr 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Other names
- Loudoun Medical Care And Wellness (Doing Business As)
Practice location
19490 Sandridge Way, Suite 240Leesburg, VA 20176-3467
Phone 571-223-5723 · Fax 703-724-0941
Mailing address
224-D Cornwall Street, Nw, Suite 403Leesburg, VA 20176-2704
Phone 703-737-6010 · Fax 703-443-8643
Authorized official
Mary Beth Tamasy
Ceo
7037376010
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