Organization
MOORE ORTHOPAEDIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN MCNALLY (CEO)
(803) 227-8152
Entity
Organization
Contact information
Practice address
7033 ST. ANDREWS ROAD, SUITE 104, COLUMBIA, SC 29212
(803) 227-8003
Mailing address
P.O. BOX 843384, BOSTON, MA 02284-3384
(803) 227-8003
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497990001
MEDICARE DME#
SC
01
—
DM0194
MEDICAID DME#
SC
05
—
PA0686
—
SC
Enumeration date
06/07/2006
Last updated
08/22/2020
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