Individual
DR. BRADLEY N HAUGSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 656-2011
Mailing address
225 S EXECUTIVE DR, BROOKFIELD, WI 53005-4266
(262) 787-4026
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35753-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32061300
—
WI
01
—
P00338880
RAIL ROAD MEDICARE
—
Enumeration date
11/25/2005
Last updated
02/14/2009
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