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General NPI Number Information
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NPI Number | 1730296310
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Entity Type | Organization
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Legal Business Name | MOORE ORTHOPAEDIC CLINIC, P.A.
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | THE PLEX 741 FASHION DRIVE
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City | COLUMBIA
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State | SC
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Zip | 29229
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Country | US
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Telephone | 803-227-8005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 843384
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City | BOSTON
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State | MA
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Zip | 02284-3384
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Country | US
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Telephone | 803-227-8000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SEAN MCNALLY
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Credential |
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Telephone | 803-227-8152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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