Loudoun Medical Group, Pc

NPI Registration Record

Provider / Organization	NPI	Date Certified
LOUDOUN MEDICAL GROUP, PC	1215051693	2023-11-10

The organization Loudoun Medical Group, Pc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1215051693. Registration indicates Loudoun Medical Group, Pc is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Otolaryngology (Otolaryngology, ) (Specialist Network, ) (Otolaryngology, Allopathic & Osteopathic Physicians)

Other Names:

Advanced Ear Nose and Throat Specialists
Advanced ENT Specialist

Entity Type	Organization

Provider Organization	LOUDOUN MEDICAL GROUP, PC
Other Provider Organization	ADVANCED ENT SPECIALIST
Practice Office Address	19490 SANDRIDGE WAY, SUITE 230 LEESBURG, VA US
Practice Office Telephone	7038585885
Practice Office Fax	7038585001
Mailing Address	224D CORNWALL ST NW STE 403 LEESBURG, VA 201762704 US
Business Telephone	7037376001
Business Fax	7034438643
Authorized Official	MARY BETH TAMASY, CEO 7037376010

Offices / Locations

Address	City / State	Phone / Fax
19490 Sandridge Way Ste 230	Leesburg, VA 201763467	7038585885 / 7038585001

HPT Codes

Code	Practice	License No State
207Y00000X PRIMARY	Allopathic & Osteopathic Physicians Otolaryngology Otolaryngology Specialist Network Otolaryngology Allopathic & Osteopathic Physicians
193200000X MULT		Group Code

OPI Codes

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