Individual
GARY JOHN MULLEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834
(252) 752-2140
(252) 689-6502
Mailing address
4030 WAKE FOREST RD STE 349, RALEIGH, NC 27609-0010
(850) 261-4322
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101268133
VA
207L00000X
Anesthesiology Physician
Primary
2009-01922
NC
207L00000X
Anesthesiology Physician
52400
SC
207L00000X
Anesthesiology Physician
88020
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156HK
BLUECROSS BLUESHIELD OF NC
NC
01
—
225134
MEDCOST
NC
05
—
5913427
—
NC
01
—
P00794665
RAILROAD MEDICARE
NC
Enumeration date
02/28/2006
Last updated
04/02/2026
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