Provider Demographics
NPI:1770711137
Name:MULROY, BRIAN JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JAMES
Last Name:MULROY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-512-1475
Mailing Address - Fax:864-512-3702
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 3700
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-1475
Practice Address - Fax:864-512-3702
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2013-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC1271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC012710Medicaid