Provider Demographics
NPI:1649326422
Name:KASHGARIAN, GUY TOREN (PHD)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:TOREN
Last Name:KASHGARIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 EASTWOOD RD STE 303
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7202
Mailing Address - Country:US
Mailing Address - Phone:910-509-0588
Mailing Address - Fax:910-509-0586
Practice Address - Street 1:2002 EASTWOOD RD STE 303
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7202
Practice Address - Country:US
Practice Address - Phone:910-509-0588
Practice Address - Fax:910-509-0586
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000333Medicaid
NC045WEOtherBLUE CROSS BLUE SHIELD
NC6000333Medicaid