Individual
DR. BRENDAN THOMAS MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-2459
(412) 359-8233
Mailing address
320 E NORTH AVE, PITTSBURGH, PA 15212-4756
(412) 359-2459
(412) 359-8233
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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