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General NPI Number Information
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NPI Number | 1821254905
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Entity Type | Organization
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Legal Business Name | LOUDOUN CENTER FOR PLASTIC SURGERY LLC
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 45155 RESEARCH PL SUITE 125
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City | ASHBURN
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State | VA
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Zip | 20147-4191
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Country | US
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Telephone | 703-726-1175
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Fax | 703-726-9975
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Provider Business Mailing Address
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Address Line | 45155 RESEARCH PL SUITE 125
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City | ASHBURN
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State | VA
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Zip | 20147-4191
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Country | US
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Telephone | 703-726-1175
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Fax | 703-726-9975
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL JOSEPH BROWN
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Credential | MD
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Telephone | 703-726-1175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 0101225608
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 0101225608
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License Number State | VA
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