Provider Demographics
NPI:1093055444
Name:KUFFNER, EDWIN KARL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:KARL
Last Name:KUFFNER
Suffix:JR
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 1:7050 CAMP HILL RD
Mailing Address - Street 2:
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2210
Mailing Address - Country:US
Mailing Address - Phone:215-273-8569
Mailing Address - Fax:
Practice Address - Street 1:7050 CAMP HILL RD
Practice Address - Street 2:
Practice Address - City:FT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2210
Practice Address - Country:US
Practice Address - Phone:215-273-8569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431331207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology