Basic Information
Provider Information
NPI: 1205143823
EntityType: 2
ReplacementNPI:  
OrganizationName: LOUDOUN MEDICAL GROUP, P.C.
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: NAUMAN J. AKHTAR, MD
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 224-D CORNWALL ST., NW, SUITE 403
Address2:  
City: LEESBURG
State: VA
PostalCode: 201762704
CountryCode: US
TelephoneNumber: 7037376010
FaxNumber: 7034439643
Practice Location
Address1: 224D CORNWALL ST NW
Address2: SUITE 204
City: LEESBURG
State: VA
PostalCode: 201762700
CountryCode: US
TelephoneNumber: 7037773262
FaxNumber: 7037773365
Other Information
ProviderEnumerationDate: 09/02/2010
LastUpdateDate: 03/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TAMASY
AuthorizedOfficialFirstName: MARY BETH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 7037376010
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: LOUDOUN MEDICAL GROUP, P.C.
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 03/10/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0114X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery

No ID Information.


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