# SSM MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maryville Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538342621
- **Authorized official:** LESA SCHNARR (DIRECTOR)
- **Authorized official phone:** (314) 951-5330

## Contact information

- **Practice address:** 6828 STATE ROUTE 162, MARYVILLE, IL 62062-8500
- **Practice address phone:** (618) 288-5084
- **Mailing address:** 7980 CLAYTON RD, SUITE 202, SAINT LOUIS, MO 63117-1354
- **Mailing address phone:** (314) 951-5368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/11/2007
- **Last updated:** 12/11/2007