Individual
STEPHEN MULLANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
2601 LAUREL ST STE 130, COLUMBIA, SC 29204-2035
(803) 227-5320
(803) 227-5326
Mailing address
PO BOX 935722, ATLANTA, GA 31193-5722
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18311
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2531
—
SC
Enumeration date
10/02/2009
Last updated
08/24/2021
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