MEDICARE: MARY COLETTE SCHMIDT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	36735	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000010050	OTHER	MO	ESSENCE
2	24287	OTHER	MO	BCBS
3	A14103	OTHER	MO	MERCY
4	138775	OTHER	MO	GHP
5	4401357	OTHER	MO	AETNA
6	101339	OTHER	MO	HEALTHLINK
7	0400603	OTHER	MO	UHC
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174504682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY COLETTE SCHMIDT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 611
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63032-0611
Country	:	US
Telephone Number	:	314-922-4048
Fax Number	:	636-333-4510

Provider Business Practice Location Address
First Line	:	4401 PARKER RD
Second Line	:
City	:	BLACK JACK
State	:	MO
Zip	:	63033-4266
Country	:	US
Telephone Number	:	314-922-4048
Fax Number	:	636-333-4510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	12/22/2023

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