| Og Emg | |
|
19450 Deerfield Avenue, Suite 200 Leesburg VA 20176 | |
| (703) 777-3262 | |
| (703) 777-3365 |
| Full Name | Og Emg |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 19450 Deerfield Avenue, Suite 200, Leesburg, Virginia |
| Authorized Official Name and Position | Mary Beth Tamasy (CEO) |
| Authorized Official Contact | 7037376010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Og Emg 224 D Cornwall Street Nw Ste 403 Leesburg VA 20176 Ph: (703) 737-6010 | Og Emg 19450 Deerfield Avenue, Suite 200 Leesburg VA 20176 Ph: (703) 777-3262 |
| NPI Number | 1538867338 |
|---|---|
| Provider Enumeration Date | 02/21/2023 |
| Last Update Date | 02/24/2023 |
| Certification Date | 02/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538867338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Primary |
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