Provider Demographics
NPI:1336431907
Name:ZHIVOTENKO, VITALIY (DO)
Entity type:Individual
Prefix:DR
First Name:VITALIY
Middle Name:
Last Name:ZHIVOTENKO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 N SCOTTSDALE RD STE B200
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-5910
Mailing Address - Country:US
Mailing Address - Phone:480-572-2444
Mailing Address - Fax:
Practice Address - Street 1:5410 N SCOTTSDALE RD STE B200
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-5910
Practice Address - Country:US
Practice Address - Phone:480-572-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2821502084N0400X, 208VP0014X
AZ008793208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology