Individual
DOMINIC BISESI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1465 S GRAND BLVD RM 2717, SAINT LOUIS, MO 63104-1003
(314) 268-4070
(314) 268-4019
Mailing address
1465 S GRAND BLVD RM 2717, SAINT LOUIS, MO 63104-1003
(314) 268-4070
(314) 268-4019
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021024445
MO
Other
Enumeration date
03/31/2021
Last updated
04/08/2025
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