Provider Demographics
NPI:1194740498
Name:SCHRAM, DAVID DOUGLAS (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:DOUGLAS
Last Name:SCHRAM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 S BOULDER AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4845
Mailing Address - Country:US
Mailing Address - Phone:918-295-7506
Mailing Address - Fax:918-295-7588
Practice Address - Street 1:1717 S BOULDER AVE STE 700
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4845
Practice Address - Country:US
Practice Address - Phone:918-295-7508
Practice Address - Fax:918-295-7588
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19370207RH0002X, 207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100091000AMedicaid
F45116Medicare UPIN