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NPI Code Detail

MEDICARE: MARY DECKER MULBRY M.D.

MEDICARE:   MARY DECKER MULBRY  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology Physician14788SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00290694OTHERSCRAILROAD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356390249
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY DECKER MULBRY M.D.
Provider Business Mailing Address
First Line : PO BOX 63345
Second Line :
City : CHARLOTTE
State : NC
Zip : 28263-3345
Country : US
Telephone Number : 843-795-7196
Fax Number :
Provider Business Practice Location Address
First Line : 316 CALHOUN ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29401-1113
Country : US
Telephone Number : 843-724-2140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 10/09/2014

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Directions to “ MARY DECKER MULBRY M.D.” Practice Location

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