Provider Demographics
NPI:1538408737
Name:CAPE FAMILY CARE LLC
Entity type:Organization
Organization Name:CAPE FAMILY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BIESER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:573-906-3850
Mailing Address - Street 1:2907 KEYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-1724
Mailing Address - Country:US
Mailing Address - Phone:573-803-2400
Mailing Address - Fax:877-516-6401
Practice Address - Street 1:2907 KEYSTONE DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-1724
Practice Address - Country:US
Practice Address - Phone:573-803-2400
Practice Address - Fax:877-516-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO246850705Medicaid
MOF54582Medicare UPIN
MO246850705Medicaid