Organization
PROVIDENCE ORTHOPAEDIC GROUP LLC
Active
Other names
Moore Orthopaedic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN P. MCNALLY (CEO)
(803) 227-8152
Entity
Organization
Contact information
Practice address
14 MEDICAL PARK RD, SUITE 200, COLUMBIA, SC 29203-6877
(803) 227-8152
(803) 227-8011
Mailing address
PO BOX 9592, BELFAST, ME 04915-9592
(803) 227-8152
(803) 227-8011
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
570521956
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0497990001
MEDICARE DME#
SC
01
—
DM0194
MEDICAID DME#
SC
05
—
PA0686
—
SC
Enumeration date
03/07/2006
Last updated
10/22/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us