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LOUDOUN MEDICAL GROUP PC NPI 1356465769


NPI Information

NPI: 1356465769
Provider Name: LOUDOUN MEDICAL GROUP, PC

Doing Business As: SKIN CANCER CENTER OF NORTHERN VIRGINIA

Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 49D1031013

Address:
19465 DEERFIELD AVENUE, SUITE 401
LEESBURG, VA
ZIP 20176
Phone: (703) 723-5700
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LOUDOUN MEDICAL GROUP, PC is a mohs-micrographic surgery dermatology in Leesburg, VA. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. LOUDOUN MEDICAL GROUP, PC NPI is 1356465769. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Skin Cancer Center Of Northern Virginia.

The provider's business location address is:

19465 DEERFIELD AVENUE, SUITE 401
LEESBURG, VA
ZIP 20176-707
Phone: (703) 723-5700
Fax: (703) 723-5778

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 49D1031013 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 4/24/2023.


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
1207ND0101XDermatologyMOHS-Micrographic SurgeryYes

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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