Highlander Dermatology Llc

LBN: Highlander Dermatology Llc
Highlander Dermatology Llc is an health care organization with primary practice located at 2607 N Grandview Blvd Ste 125, Waukesha WI 53188-1686. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Highlander Dermatology Llc can be contacted via phone (414) 455-0919, or through Straka, Bradley T.J. via phone (414) 899-2385.

Contact Information

Primary practice address
2607 N Grandview Blvd Ste 125 Waukesha WI 53188-1686
Phone: (414) 455-0919
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Straka, Bradley T.J. Doctor of Medicine (MD)
Phone: (414) 899-2385

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X H059290 Wisconsin

Profile Details

NPI number 1790216554
LBN Legal business name Highlander Dermatology Llc
DBA Doing business as
Authorized official Straka, Bradley T.J. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 23rd, 2017
Last updated Jul 21st, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790216554 NPPES
Wisconsin Other 1326031964 SOLE OWNER NPI: 1326031964. HIGHLANDER LLC TIN:

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