Provider Demographics
NPI:1851589642
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:
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 1:13700 W NATIONAL AVE
Mailing Address - Street 2:SUITE 128
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-9521
Mailing Address - Country:US
Mailing Address - Phone:262-782-3668
Mailing Address - Fax:262-782-7335
Practice Address - Street 1:13700 W NATIONAL AVE
Practice Address - Street 2:SUITE 128
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-9521
Practice Address - Country:US
Practice Address - Phone:262-782-3668
Practice Address - Fax:262-782-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2010-05-20
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
WI100001588Medicaid
WI000081155Medicare PIN
WI0001Medicare PIN
WI43205600Medicaid
WI480010903Medicare PIN
WIT77544Medicare UPIN