Provider Demographics
NPI:1306883798
Name:VIRGINIA ADULT & PEDIATRIC ALLERGY & ASTHMA PC
Entity type:Organization
Organization Name:VIRGINIA ADULT & PEDIATRIC ALLERGY & ASTHMA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:BLUMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-288-0055
Mailing Address - Street 1:7605 FOREST AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4938
Mailing Address - Country:US
Mailing Address - Phone:804-288-0055
Mailing Address - Fax:804-288-2659
Practice Address - Street 1:7605 FOREST AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4938
Practice Address - Country:US
Practice Address - Phone:804-288-0055
Practice Address - Fax:804-288-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Not Answered332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA001852OtherANTHEM
VA192047OtherANTHEM
VA110161OtherANTHEM
VA382746OtherANTHEM
VA382746OtherANTHEM
VA110161OtherANTHEM