Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 0101230485 | VA |
NPI | 1881639375 |
---|---|
Provider Name | Dr. Sergey Zhitar |
First Address | Cincinnati, OH 45202-1457 |
Second Address | Virginia Beach, VA 23452-7523 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2006 |
Last Update Date | 28/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010216125 | (05) | VA |
10000509 | SENTARA (01) | VA |
184792 | ANTHEM (01) | VA |
414193 | SOUTHERN HEALTH (01) | VA |
463685117 | VIRGINIA HEALTH NETWORK (01) | VA |
7269202 | AETNA (01) | VA |
H31305 | (02) | VA |