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Individual

BRADLEY NATHANAEL LEMKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 JOHN Q HAMMONS DR, STE 101, MADISON, WI 53717
(608) 829-7777
(608) 829-7778
Mailing address
1200 JOHN Q HAMMONS DR, STE 101, MADISON, WI 53717
(608) 829-7777
(608) 829-7778

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036111560
IL
207W00000X
Ophthalmology Physician
Primary
20222020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
211192
MEDICARE CMS WPS STATE OF
IL
05
30337700
WI
Enumeration date
10/04/2006
Last updated
07/08/2007
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