Provider Demographics
NPI:1225134109
Name:JAUFMANN, BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:JAUFMANN
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:PO BOX 9788
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9788
Mailing Address - Country:US
Mailing Address - Phone:910-295-0215
Mailing Address - Fax:910-295-0218
Practice Address - Street 1:5 FIRST VILLAGE DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8724
Practice Address - Country:US
Practice Address - Phone:910-295-0215
Practice Address - Fax:910-295-0218
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36741207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCFH2967575OtherFIRSTCAROLINA CARE
NC8945847Medicaid
NC45847OtherBLUE CROSS BLUE SHIELD
F54063Medicare UPIN
NC8945847Medicaid