| Loudoun Medical Group, Pc | |
|
13505 Dulles Technology Drive, Suite 1a Herndon VA 20171-3404 | |
| (703) 404-5900 | |
| (703) 421-1099 |
| Full Name | Loudoun Medical Group, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 13505 Dulles Technology Drive, Suite 1a, Herndon, Virginia |
| Authorized Official Name and Position | Mary Beth Tamasy (CEO) |
| Authorized Official Contact | 7037376010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loudoun Medical Group, Pc 224-d Cornwall Street, Nw, Suite 403 Leesburg VA 20176-2704 Ph: (703) 737-6010 | Loudoun Medical Group, Pc 13505 Dulles Technology Drive, Suite 1a Herndon VA 20171-3404 Ph: (703) 404-5900 |
| NPI Number | 1720358179 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 04/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720358179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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