Provider Demographics
NPI:1629698865
Name:MUHAMMAD, UMER (MD)
Entity Type:Individual
Prefix:MR
First Name:UMER
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E 50TH ST
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-4920
Mailing Address - Country:US
Mailing Address - Phone:417-556-3416
Mailing Address - Fax:417-556-3417
Practice Address - Street 1:202 E 50TH ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4920
Practice Address - Country:US
Practice Address - Phone:417-556-3416
Practice Address - Fax:417-556-3417
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2023-07-05
Deactivation Date:2022-01-10
Deactivation Code:
Reactivation Date:2022-02-24
Provider Licenses
StateLicense IDTaxonomies
MO2023026711208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics