MEDICARE: DR. SERGEY ZHITAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0401X	Addiction Medicine (Internal Medicine) Physician	0101230485	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	184792	OTHER	VA	ANTHEM
3	10000509	OTHER	VA	SENTARA
4	463685117	OTHER	VA	VIRGINIA HEALTH NETWORK
5	414193	OTHER	VA	SOUTHERN HEALTH
6	7269202	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1881639375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERGEY ZHITAR MD

Provider Business Mailing Address
First Line	:	615 ELSINORE PL STE 200
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-1457
Country	:	US
Telephone Number	:	513-834-7063
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N LYNNHAVEN RD
Second Line	:	SUITE 100
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-7523
Country	:	US
Telephone Number	:	757-264-9957
Fax Number	:	757-963-0444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	12/28/2021

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Directions to “ DR. SERGEY ZHITAR MD” Practice Location

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