Provider Demographics
NPI:1760718704
Name:SCHRAM, NICKLAUS AUGUST (DC)
Entity Type:Individual
Prefix:DR
First Name:NICKLAUS
Middle Name:AUGUST
Last Name:SCHRAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CULPEPER ST
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-3227
Mailing Address - Country:US
Mailing Address - Phone:502-349-2009
Mailing Address - Fax:502-349-3090
Practice Address - Street 1:201 CULPEPER ST
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-3227
Practice Address - Country:US
Practice Address - Phone:502-349-2009
Practice Address - Fax:502-349-3090
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-011541111N00000X
KY5248111N00000X
IN08002825A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100164500Medicaid
KYK141300Medicare PIN