Provider Demographics
NPI:1932123916
Name:STRAKA, SCOTT D (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:STRAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-2306
Mailing Address - Country:US
Mailing Address - Phone:402-335-2811
Mailing Address - Fax:402-335-2826
Practice Address - Street 1:509 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2306
Practice Address - Country:US
Practice Address - Phone:402-335-2811
Practice Address - Fax:402-335-2826
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE50122OtherBCBS NE
NE096938005Medicare PIN
NEH45831Medicare UPIN