Organization
SSM MEDICAL GROUP
Active
Other names
Mid County Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
LESA SCHNARR (DIRECTOR)
(314) 951-5330
Entity
Organization
Contact information
Practice address
1031 BELLEVUE AVE, SUITE 300, SAINT LOUIS, MO 63117-1818
(314) 644-0042
(314) 644-1507
Mailing address
7980 CLAYTON RD, SUITE 202, SAINT LOUIS, MO 63117-1354
(314) 951-5368
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG1303
RAILROAD MEDICARE
MO
Enumeration date
11/27/2007
Last updated
01/24/2008
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