Individual
DR. BRENDAN THOMAS MULLEN
Active
Individual
DR. BRENDAN THOMAS MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35.099448
OH
2085R0202X
Diagnostic Radiology Physician
Primary
MD445358
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066775
—
OH
01
—
204881619259
CARESOURCE
OH
01
—
35.099448
LICENSE
OH
01
—
684692
WELLCARE
OH
01
—
P01085366
RAILROAD MEDICARE
OH
Enumeration date
06/20/2007
Last updated
10/06/2020
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