Provider Demographics
NPI:1689783763
Name:SCHRAM, DAVID J (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:SCHRAM
Suffix:
Gender:M
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:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68902-0968
Mailing Address - Country:US
Mailing Address - Phone:402-462-8456
Mailing Address - Fax:402-463-9697
Practice Address - Street 1:1021 W 14TH ST
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3046
Practice Address - Country:US
Practice Address - Phone:402-463-2423
Practice Address - Fax:402-463-9697
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE34320OtherBCBS NE
NEP00043323OtherRAILROAD MEDICARE
NE47061821913Medicaid
NEP00043323OtherMEDICARE RAILROAD
NE276759Medicare ID - Type UnspecifiedNEBRASKA MEDICARE
NE47061821913Medicaid