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General NPI Number Information
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NPI Number | 1235553546
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Entity Type | Individual
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Provider Name | PATRICK CONNOR MULLANE
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Gender | Male
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 171 ASHLEY AVE DEPT OF
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City | CHARLESTON
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State | SC
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Zip | 29425-9080
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Country | US
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Telephone | 850-274-9116
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Fax |
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Provider Business Mailing Address
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Address Line | 171 ASHLEY AVE DEPT OF
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City | CHARLESTON
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State | SC
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Zip | 29425-9080
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Country | US
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Telephone | 850-274-9116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 92308
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 103992
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License Number State | GA
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