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General NPI Number Information
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NPI Number | 1518964790
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Entity Type | Individual
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Provider Name | BRADFORD B MULLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 955 EASTWIND DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-3376
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Country | US
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Telephone | 614-268-9561
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Fax | 614-268-7849
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Provider Business Mailing Address
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Address Line | 955 EASTWIND DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-3376
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Country | US
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Telephone | 614-268-9561
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Fax | 614-268-7849
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 35059100M
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License Number State | OH
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