Healthcare Provider Details

I. General information

NPI: 1306883798
Provider Name (Legal Business Name): VIRGINIA ADULT & PEDIATRIC ALLERGY & ASTHMA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7605 FOREST AVE SUITE 103
RICHMOND VA
23229-4938
US

IV. Provider business mailing address

7605 FOREST AVE SUITE 103
RICHMOND VA
23229-4938
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-0055
  • Fax: 804-288-2659
Mailing address:
  • Phone: 804-288-0055
  • Fax: 804-288-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL Z BLUMBERG
Title or Position: MANAGING DIRECTOR
Credential: MD
Phone: 804-288-0055