Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI # | 1205522810 |
| LBN Legal business name | LOUDOUN MEDICAL GROUP, PC |
| Authorized official | MARY BETH TAMASY - (CEO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 04/17/2023 |
| Last updated | 04/17/2023 - About 3 years ago |
| Identifiers | n/a |
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