Doctor profile · Federal record
Dr. Shane Mull, M.D.
Family Medicine Physician · Emergency Medicine Physician · Family Medicine Physician · Columbia, SC
- NPI 1699786079
- 20 yrs on file
- Licensed in 2 states
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
3209 Colonial Dr, USC- Family & Preventive Medicine
Columbia, SC 292036930
(803) 434-6113
fax (803) 434-7231 - Mailing address
-
234 Westlake Farms Dr
Blythewood, SC 290168325
Credentials & registration
- NPI registered
- August 2006 — 20 yrs on file
- Profile last updated
- March 26, 2015
- Specialty taxonomy
- 207Q00000X — NUCC code
- State licenses (2)
- South Carolina #23962 · North Carolina #2009-01329
- Medicaid
- SC #LL4378
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1699786079. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$78
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| ASD Specialty Healthcare, LLC | 1 | $78.45 |
By nature of payment
Frequently asked questions
What is Dr. Shane Mull's medical specialty?
Dr. Shane Mull practices Family Medicine Physician in Columbia, SC.
Where does Dr. Shane Mull practice?
Dr. Shane Mull practices at 3209 Colonial Dr, Columbia, SC 292036930. Office phone: 8034346113.
What is Dr. Shane Mull's NPI?
Dr. Shane Mull's National Provider Identifier (NPI) is 1699786079, issued by NPPES.