Provider Demographics
NPI:1174624977
Name:ROBERT A SCHRAMEYER DDS PC
Entity type:Organization
Organization Name:ROBERT A SCHRAMEYER DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHRAMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-227-2552
Mailing Address - Street 1:801 PINEVIEW TRAILS COURT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021
Mailing Address - Country:US
Mailing Address - Phone:636-227-2555
Mailing Address - Fax:
Practice Address - Street 1:14738 MANCHESTER ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011
Practice Address - Country:US
Practice Address - Phone:636-227-2552
Practice Address - Fax:636-227-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO102715OtherBLUE CROSS BLUE SHIELD
MO12401OtherDELTA DENTAL