Provider Demographics
NPI:1043971922
Name:DAISY MAE FAMILY MEDICINE PLLC
Entity Type:Organization
Organization Name:DAISY MAE FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-271-0500
Mailing Address - Street 1:20400 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3242
Mailing Address - Country:US
Mailing Address - Phone:313-271-0500
Mailing Address - Fax:313-271-9313
Practice Address - Street 1:20400 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3242
Practice Address - Country:US
Practice Address - Phone:313-271-0500
Practice Address - Fax:313-271-9313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty