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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