Provider Demographics
NPI:1790716470
Name:KAUFMANN, STEVE VINCENT (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:VINCENT
Last Name:KAUFMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:829 N CENTER AVE
Mailing Address - Street 2:SUITE 298
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1595
Mailing Address - Country:US
Mailing Address - Phone:989-731-7708
Mailing Address - Fax:989-731-7929
Practice Address - Street 1:829 N CENTER AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1595
Practice Address - Country:US
Practice Address - Phone:989-731-7930
Practice Address - Fax:989-731-7948
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013025208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4384865Medicaid
11280103OtherCAQH PROVIDER ID
MI3556910084OtherBCBSM
381303843OtherTAX ID
11280103OtherCAQH PROVIDER ID