Mary Beth Chismarich, M.D.
Pediatrics in Saint Louis, MO. Individual provider (NPI-1).
NPI number1871600379
StatusActive
Last updated in NPPESMay 5, 2011
Details
- NPI
- 1871600379
- Entity type
- Individual (NPI-1)
- Name
- Mary Beth Chismarich
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 23, 2006
- Last updated
- May 5, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 2000157483 | MO | Yes |
Other names
- Mary Beth Bange (Former Name)
Practice location
621 S New Ballas RdSuite: 6006-B
Saint Louis, MO 63141-8232
Phone 314-251-6299 · Fax 314-251-4450
Mailing address
621 S New Ballas RdSuite: 6006-B
Saint Louis, MO 63141-8232
Phone 314-251-6299 · Fax 314-251-4450
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