MEDICARE: SCOTT D STRAKA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	21821	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50122	OTHER	NE	BCBS NE

General Provider Information

NPI Number	:	1932123916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT D STRAKA MD

Provider Business Mailing Address
First Line	:	509 BROADWAY ST
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-2306
Country	:	US
Telephone Number	:	402-335-2811
Fax Number	:	402-335-2826

Provider Business Practice Location Address
First Line	:	509 BROADWAY ST
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-2306
Country	:	US
Telephone Number	:	402-335-2811
Fax Number	:	402-335-2826

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	11/29/2011

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Directions to “ SCOTT D STRAKA MD” Practice Location

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