Provider Demographics
NPI:1437469723
Name:KUFEL, JEFFREY M (PA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:KUFEL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6509 EARLY LILY ROW
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-6057
Mailing Address - Country:US
Mailing Address - Phone:443-928-9420
Mailing Address - Fax:410-701-4481
Practice Address - Street 1:8455 COLESVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3315
Practice Address - Country:US
Practice Address - Phone:301-588-0505
Practice Address - Fax:301-588-0506
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004219363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant