Organization
HIGHLANDER DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY T.J. STRAKA M.D. (OWNER)
(414) 899-2385
Entity
Organization
Contact information
Practice address
16650 W BLUEMOUND RD STE 600, BROOKFIELD, WI 53005-5970
(262) 290-4540
(262) 299-6435
Mailing address
16650 W BLUEMOUND RD STE 600, BROOKFIELD, WI 53005-5970
(262) 290-4540
(262) 299-6435
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
H059290
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215992979
NPI
WI
05
—
1215992979
—
WI
01
—
1326031964
SOLE OWNER NPI: 1326031964. HIGHLANDER LLC TIN:
WI
05
—
1326031964
—
WI
01
—
1346499738
NPI
WI
05
—
1346499738
—
WI
01
—
1518950153
NPI
WI
05
—
1518950153
—
WI
01
—
1912942285
NPI
WI
05
—
1912942285
—
WI
Enumeration date
03/23/2017
Last updated
08/09/2024
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