Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | AS400226 | MI |
NPI | 1013912724 |
---|---|
Provider Name | Alan Schram |
First Address | West Bloomfield, MI 48322-2218 |
Second Address | Allen Park, MI 48101-2034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 17/12/2009 |