Individual
DR. GRANT NICHOLAS BLEEKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3015 N BALLAS RD, ST LOUIS, MO 63131
(314) 996-5000
Mailing address
3015 N BALLAS RD, ST LOUIS, MO 63131
(314) 996-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2014005675
MO
207L00000X
Anesthesiology Physician
APPLICATION ACTIVE
IA
Other
Enumeration date
05/04/2010
Last updated
05/23/2024
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