Provider Demographics
NPI:1134287592
Name:SCHRAMM, DANIELLE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:SCHRAMM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 137
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2809
Mailing Address - Country:US
Mailing Address - Phone:248-792-5200
Mailing Address - Fax:248-712-4214
Practice Address - Street 1:3310 W BIG BEAVER RD
Practice Address - Street 2:SUITE 137
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2809
Practice Address - Country:US
Practice Address - Phone:248-792-5200
Practice Address - Fax:248-712-4214
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDS080725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4830084Medicaid
MI080F373970OtherBC
MI4830084Medicaid
MI4830084Medicaid