| Blossom Pain Management | |
|
801 Greenbrier Pkwy Ste B Chesapeake VA 23320-3822 | |
| (757) 819-7547 | |
| (757) 842-6570 |
| Full Name | Blossom Pain Management |
|---|---|
| Speciality | Family Medicine |
| Location | 801 Greenbrier Pkwy Ste B, Chesapeake, Virginia |
| Authorized Official Name and Position | Ruth Ann Watson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7578197547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Pain Management 801 Greenbrier Pkwy Ste B Chesapeake VA 23320-3822 Ph: (757) 819-7547 | Blossom Pain Management 801 Greenbrier Pkwy Ste B Chesapeake VA 23320-3822 Ph: (757) 819-7547 |
| NPI Number | 1922510361 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 01/04/2022 |
| Certification Date | 01/04/2022 |
| Medicare PECOS PAC ID | 0648664946 |
|---|---|
| Medicare Enrollment ID | O20220302003011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922510361 | NPI | - | NPPES |
| Provider Name | Sergey N Zhitar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881639375 PECOS PAC ID: 9234184193 Enrollment ID: I20050314001039 |
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