Provider Demographics
NPI:1760863310
Name:MULLINS, BRANDON (MD, MS)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:MULLINS
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MACNIDER HL
Mailing Address - Street 2:CAMPUS BOX #7005
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7005
Mailing Address - Country:US
Mailing Address - Phone:919-966-4468
Mailing Address - Fax:919-843-5945
Practice Address - Street 1:125 MACNIDER HL
Practice Address - Street 2:CAMPUS BOX #7005
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7005
Practice Address - Country:US
Practice Address - Phone:919-966-4468
Practice Address - Fax:919-843-5945
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012691662085R0001X
NC209917390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty