LOUDOUN MEDICAL GROUP PC NPI 1295290286

NPI Information

  • NPI: 1295290286
  • Provider Name: LOUDOUN MEDICAL GROUP, PC
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • Doing Business As: THE UROLOGY GROUP-GARY FIALK, MD
  • CLIA Number: 49D0222574
  • Address: 1860 TOWN CENTER DRIVE, SUITE 150
    RESTON, VA
    ZIP 20190
  • Phone: (703) 689-3311

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NPI Details

LOUDOUN MEDICAL GROUP, PC is an urology in Reston, VA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. LOUDOUN MEDICAL GROUP, PC NPI is 1295290286. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Urology Group-gary Fialk, Md.

The provider's business location address is:

1860 TOWN CENTER DRIVE, SUITE 150
RESTON, VA
ZIP 20190-905
Phone: (703) 689-3311
Fax: (703) 435-0137

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 CLIA number assigned to this NPI record is 49D0222574 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/5/2019 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
1208800000XUrologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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