Provider Demographics
NPI:1679583967
Name:ERGUN, MEHMET ALI (DC)
Entity Type:Individual
Prefix:MR
First Name:MEHMET
Middle Name:ALI
Last Name:ERGUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 RAMSEY ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-3183
Mailing Address - Country:US
Mailing Address - Phone:910-488-4477
Mailing Address - Fax:910-488-3577
Practice Address - Street 1:3217 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3183
Practice Address - Country:US
Practice Address - Phone:910-488-4477
Practice Address - Fax:910-488-3577
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
5167042OtherAETNA
609654OtherACN
153704700OtherACS
562009826OtherTRIAD
4313519OtherCSI
562009826OtherUNITED HEALTHCARE
0843POtherBCBS
562009826OtherCIGNA
562009826OtherHUMANA
NC890843PMedicaid