Provider Demographics
NPI:1285048546
Name:LOUDOUN FAMILY MEDICINE LLC
Entity type:Organization
Organization Name:LOUDOUN FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALARMATHI
Authorized Official - Middle Name:T
Authorized Official - Last Name:ANBARASAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-342-7790
Mailing Address - Street 1:20969 GREAT WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-8776
Mailing Address - Country:US
Mailing Address - Phone:703-342-7790
Mailing Address - Fax:
Practice Address - Street 1:19415 DEERFIELD AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8452
Practice Address - Country:US
Practice Address - Phone:703-858-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty