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General NPI Number Information
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NPI Number | 1679591440
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Entity Type | Organization
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Legal Business Name | LOUDOUN MEDICAL GROUP, PC
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 224D CORNWALL ST NW SUITE 403
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City | LEESBURG
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State | VA
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Zip | 20176-2700
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Country | US
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Telephone | 703-737-6010
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Fax | 703-443-8643
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Provider Business Mailing Address
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Address Line | PO BOX 17334
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City | BALTIMORE
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State | MD
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Zip | 21297-1334
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Country | US
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Telephone | 703-443-6717
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Fax | 703-443-8643
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Authorized Official
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Title or Position | CEO
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Name | MARY BETH TAMASY
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Credential |
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Telephone | 703-737-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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