Provider Demographics
NPI:1003885856
Name:KAUFMAN, ROBERT BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BERNARD
Last Name:KAUFMAN
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 1:10013 WEATHERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2171
Mailing Address - Country:US
Mailing Address - Phone:301-279-7448
Mailing Address - Fax:
Practice Address - Street 1:26135 RIDGE RD
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:MD
Practice Address - Zip Code:20872-1867
Practice Address - Country:US
Practice Address - Phone:301-253-6565
Practice Address - Fax:301-253-1659
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019071207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD251491500Medicaid
MDC61998Medicare UPIN
MD251491500Medicaid