Organization
MISSOURI MEDICAL PROVIDERS LLC
Active
Organization
MISSOURI MEDICAL PROVIDERS LLC
Active
Other names
Solutions Medical Provider Services
Organization subpart
No
Provider details
NPI number
Authorized official
OMER MALIK (OWNER)
(573) 382-3301
Entity
Organization
Contact information
Practice address
2215 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4403
(636) 725-1255
(573) 534-3131
Mailing address
2215 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4403
(636) 725-1255
(573) 534-3131
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043817323
NPI
MO
05
—
500090302
—
MO
Enumeration date
10/08/2020
Last updated
04/13/2026
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