Individual
BRANDON ROBERT MCMULLEN
Active
Individual
BRANDON ROBERT MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0004697
MARYLAND STATE LICENSE
MD
01
—
C5-0000821
DE PA LICENSE
DE
Enumeration date
02/13/2012
Last updated
10/21/2022
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