Loudoun Medical Group, PC
Specialist in Leesburg, VA. Organization (NPI-2).
NPI number1982148441
StatusActive
Last updated in NPPESApr 24, 2023
Details
- NPI
- 1982148441
- Entity type
- Organization (NPI-2)
- Legal business name
- Loudoun Medical Group, PC
- Organization subpart
- Yes
- Enumeration date
- Dec 16, 2016
- Certification date
- Apr 24, 2023
- Last updated
- Apr 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Other names
- Center For Spinal Surgery & Spinal Disorders (Doing Business As)
Practice location
19450 Deerfield Avenue, Suite 200Leesburg, VA 20176-6821
Phone 703-777-1553 · Fax 703-777-5524
Mailing address
224d Cornwall Street, Nw,Ste 403
Leesburg, VA 20176-2700
Phone 703-737-6010 · Fax 703-443-8643
Authorized official
Mary Beth Tamasy
Ceo
7037376010
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