Provider Demographics
NPI:1083898795
Name:STEVEN E. KAUFMAN D.P.M., S.C.
Entity Type:Organization
Organization Name:STEVEN E. KAUFMAN D.P.M., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:414-383-2995
Mailing Address - Street 1:3615 W OKLAHOMA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4100
Mailing Address - Country:US
Mailing Address - Phone:414-383-2995
Mailing Address - Fax:414-383-2918
Practice Address - Street 1:3535 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4171
Practice Address - Country:US
Practice Address - Phone:414-383-2995
Practice Address - Fax:414-383-2918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI573-025213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43205600Medicaid
WIT77544Medicare UPIN
WI000082966Medicare PIN
WI480010903Medicare PIN
WI43205600Medicaid
WI0001Medicare PIN