Healthcare Provider Details

I. General information

NPI: 1194740498
Provider Name (Legal Business Name): DAVID DOUGLAS SCHRAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 S BOULDER AVE STE 700
TULSA OK
74119-4845
US

IV. Provider business mailing address

1717 S BOULDER AVE STE 700
TULSA OK
74119-4845
US

V. Phone/Fax

Practice location:
  • Phone: 918-295-7508
  • Fax: 918-295-7588
Mailing address:
  • Phone: 918-295-7506
  • Fax: 918-295-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number19370
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number19370
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19370
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: