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General NPI Number Information
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NPI Number | 1881639375
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Entity Type | Individual
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Provider Name | SERGEY ZHITAR MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 101 N LYNNHAVEN RD SUITE 100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7523
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Country | US
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Telephone | 757-264-9957
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Fax | 757-963-0444
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Provider Business Mailing Address
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Address Line | 615 ELSINORE PL STE 200
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City | CINCINNATI
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State | OH
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Zip | 45202-1457
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Country | US
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Telephone | 513-834-7063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 0101230485
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License Number State | VA
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