Individual
JEFFREY GRIESEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1403 E MARSHALL ST, CHARLESTON, MO 63834
(573) 683-2327
Mailing address
1008 N MAIN ST, SIKESTON, MO 63801-5044
(573) 683-2327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011002939
MO
390200000X
Student in an Organized Health Care Education/Training Program
125054803
IL
Other
Enumeration date
06/12/2008
Last updated
10/22/2011
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