Provider Demographics
NPI:1932498086
Name:KAUFMAN, WILLIAM SARGENT (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SARGENT
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6781 PARKER FARM DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-3160
Mailing Address - Country:US
Mailing Address - Phone:910-763-1555
Mailing Address - Fax:910-762-4726
Practice Address - Street 1:6781 PARKER FARM DR
Practice Address - Street 2:SUITE 300
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3160
Practice Address - Country:US
Practice Address - Phone:910-763-1555
Practice Address - Fax:910-762-4726
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00569207N00000X
VAN/A MEDICAL STUDENT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology