Provider Demographics
NPI:1316970544
Name:ORAM, DAVID W (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:ORAM
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 1:2051 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3948
Mailing Address - Country:US
Mailing Address - Phone:419-291-2051
Mailing Address - Fax:419-479-6952
Practice Address - Street 1:2051 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3948
Practice Address - Country:US
Practice Address - Phone:419-291-2051
Practice Address - Fax:419-479-6952
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4756399Medicaid
MI080A610030OtherGROUP BLUE CROSS
MI0160012OtherINDIVIDUAL BLUE CROSS
OH3047625Medicaid
A66000045Medicare ID - Type Unspecified
MI080A610030OtherGROUP BLUE CROSS
MI4756399Medicaid