Individual
BENJAMIN MULLENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1241 WOODLAND AVE, MT PLEASANT, SC 29464-3288
(843) 824-0606
(843) 824-0909
Mailing address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1242
(704) 446-1241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
201220
NC
2085R0202X
Diagnostic Radiology Physician
Primary
MD83497
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12501Q
—
SC
Enumeration date
05/07/2014
Last updated
03/04/2021
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