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LOUDOUN MEDICAL GROUP PC NPI 1093339764


NPI Information

NPI: 1093339764
Provider Name: LOUDOUN MEDICAL GROUP, PC

Doing Business As: SKIN CANCER CENTER OF NORTHERN VIRGINIA

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
19500 SANDRIDGE WAY STE 400
LEESBURG, VA
ZIP 20176
Phone: (703) 723-5700
Get Directions

LOUDOUN MEDICAL GROUP, PC is a hematology and oncology internal medicine in Leesburg, VA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. LOUDOUN MEDICAL GROUP, PC NPI is 1093339764. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Skin Cancer Center Of Northern Virginia.

The provider's business location address is:

19500 SANDRIDGE WAY STE 400
LEESBURG, VA
ZIP 20176-691
Phone: (703) 723-5700

The provider's authorized official is Mary Beth Tamasy .
The authorized official title is Ceo and has the following contact phone number (703) 737-6010.

The enumeration date for this NPI number is 5/29/2020 and was last updated on 8/18/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11675951440MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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