Provider Demographics
NPI:1548657422
Name:CANASTAR, MEHTAP DOGAN
Entity type:Individual
Prefix:DR
First Name:MEHTAP
Middle Name:DOGAN
Last Name:CANASTAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEHTAP
Other - Middle Name:
Other - Last Name:DOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-8300
Mailing Address - Fax:910-662-8361
Practice Address - Street 1:1520 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7356
Practice Address - Country:US
Practice Address - Phone:910-662-8300
Practice Address - Fax:910-662-8361
Is Sole Proprietor?:No
Enumeration Date:2015-04-18
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC391014207R00000X
390200000X
NC2021-01612207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program