Jeffrey Griesemer, MD
Family Medicine in Charleston, MO. Individual provider (NPI-1).
NPI number1851551907
StatusActive
Last updated in NPPESOct 22, 2011
Details
- NPI
- 1851551907
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey Griesemer
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2008
- Last updated
- Oct 22, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 2011002939 | MO | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 125054803 | IL |
Practice location
1403 E Marshall StCharleston, MO 63834
Phone 573-683-2327
Mailing address
1008 N Main StSikeston, MO 63801-5044
Phone 573-683-2327
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