Basic Information
Provider Information
NPI: 1982981924
EntityType: 2
ReplacementNPI:  
OrganizationName: LOUDOUN MEDICAL GROUP, PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NAUMAN J. AKHTAR, MD
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 224D CORNWALL ST NW STE 403
Address2:  
City: LEESBURG
State: VA
PostalCode: 201762704
CountryCode: US
TelephoneNumber: 7037376001
FaxNumber: 5712919786
Practice Location
Address1: 19450 DEERFIELD AVENUE, SUITE 200
Address2:  
City: LEESBURG
State: VA
PostalCode: 201766821
CountryCode: US
TelephoneNumber: 5712091875
FaxNumber: 7037773365
Other Information
ProviderEnumerationDate: 11/04/2011
LastUpdateDate: 09/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TAMASY
AuthorizedOfficialFirstName: MARY BETH
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 7037376010
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: LOUDOUN MEDICAL GROUP, PC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home