Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northwest Missouri State University

Organization Family Medicine Physician · NPI 1225310204

Northwest Missouri State University is a Family Medicine Physician in Maryville, Missouri. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
2

Practice location Address checks out

800 University Dr
Maryville, MO 64468
Phone: (660) 562-1313
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1225310204
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Cannella — Head Athletic Trainer · (660) 562-1313
Other names Northwest Missouri State
NPI enumeratedSeptember 15, 2011
Last updated in NPPESFebruary 21, 2022
Certification dateFebruary 21, 2022
Mailing address800 University Drive, Maryville, MO 64468

Other providers in Maryville