Provider Demographics
NPI:1588864813
Name:ZLATEV, TINKO IVANOV (MD)
Entity type:Individual
Prefix:DR
First Name:TINKO
Middle Name:IVANOV
Last Name:ZLATEV
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 1:930 SW ABBEY ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-4820
Mailing Address - Country:US
Mailing Address - Phone:541-265-2244
Mailing Address - Fax:541-574-1838
Practice Address - Street 1:930 SW ABBEY ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4820
Practice Address - Country:US
Practice Address - Phone:541-265-2244
Practice Address - Fax:541-574-1838
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD244322085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR115376Medicare PIN
G29893Medicare UPIN