Provider Demographics
NPI:1568433225
Name:ZIENO, SALVATORE A (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:A
Last Name:ZIENO
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:PO BOX 3439
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-0439
Mailing Address - Country:US
Mailing Address - Phone:843-839-4447
Mailing Address - Fax:
Practice Address - Street 1:3361 HIGHWAY 9 E
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-7826
Practice Address - Country:US
Practice Address - Phone:843-497-5929
Practice Address - Fax:866-778-9612
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17722207Y00000X
IA29480207Y00000X
SC40456207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1238365OtherFED CONTROLLED SUBSTANCE
IA1238365OtherST CONT SUBSTANCE
SC404565Medicaid
IA94583OtherBLUE CROSS BLUE SHIELD
NEBZ1604621NOtherST CONT SUBSTANCE
NE00652OtherBLUE CROSS BLUE SHIELD
NEBZ1604621OtherFED CONTROLLED SUBSTANCE
IA0919548Medicaid
F40837Medicare UPIN
NEBZ1604621NOtherST CONT SUBSTANCE