Healthcare Provider Details

I. General information

NPI: 1770111734
Provider Name (Legal Business Name): JUSTIN T SCHRAMM D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 09/14/2023
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 W CENTER RD
OMAHA NE
68106
US

IV. Provider business mailing address

7100 W CENTER RD
OMAHA NE
68106
US

V. Phone/Fax

Practice location:
  • Phone: 402-506-9000
  • Fax: 402-506-9001
Mailing address:
  • Phone: 402-506-9097
  • Fax: 402-315-2711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2596
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: