Provider Demographics
NPI:1942420336
Name:BLITCH, JAMES B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:BLITCH
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1810 MICHAEL FARADAY DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:703-435-4434
Mailing Address - Fax:703-435-1704
Practice Address - Street 1:1810 MICHAEL FARADAY DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-435-4434
Practice Address - Fax:703-435-1704
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2011-12-07
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Provider Licenses
StateLicense IDTaxonomies
VA01010205082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA408746Medicare ID - Type Unspecified