Provider Demographics
NPI:1881639375
Name:ZHITAR, SERGEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGEY
Middle Name:
Last Name:ZHITAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 ELSINORE PL STE 200
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1457
Mailing Address - Country:US
Mailing Address - Phone:513-834-7063
Mailing Address - Fax:
Practice Address - Street 1:101 N LYNNHAVEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7523
Practice Address - Country:US
Practice Address - Phone:757-264-9957
Practice Address - Fax:757-963-0444
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230485207RA0401X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010216125Medicaid
VA184792OtherANTHEM
VA10000509OtherSENTARA
VA463685117OtherVIRGINIA HEALTH NETWORK
VA414193OtherSOUTHERN HEALTH
VA7269202OtherAETNA
VA414193OtherSOUTHERN HEALTH
VAH31305Medicare UPIN