Loudoun Medical Group, PC
Otolaryngology in Alexandria, VA. Organization (NPI-2).
NPI number1962114801
StatusActive
Last updated in NPPESAug 18, 2023
Details
- NPI
- 1962114801
- Entity type
- Organization (NPI-2)
- Legal business name
- Loudoun Medical Group, PC
- Organization subpart
- Yes
- Enumeration date
- Dec 22, 2022
- Certification date
- Aug 18, 2023
- Last updated
- Aug 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | – | – | Yes |
Other names
- Loudoun Medical Group, PC "d" (Doing Business As)
Practice location
6355 Walker Lane, Suite 308Alexandria, VA 22310-3247
Phone 703-737-6010
Mailing address
224-D Cornwall Street, Nw, Suite 403Leesburg, VA 20176-2704
Phone 703-737-6010
Authorized official
Mary Beth Tamasy
Ceo
7037376010
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