Provider Demographics
NPI:1932123353
Name:SALVADOR, VIVIAN ELIZA B (DO)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN ELIZA
Middle Name:B
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:520 S VAN BUREN RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5201
Mailing Address - Country:US
Mailing Address - Phone:336-627-5437
Mailing Address - Fax:336-627-1681
Practice Address - Street 1:520 S VAN BUREN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5201
Practice Address - Country:US
Practice Address - Phone:336-627-5437
Practice Address - Fax:336-627-1681
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2006-00284208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909547Medicaid
NC010396409Medicaid
VA10396409Medicaid