Basic Information
Provider Information
NPI: 1629230297
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAUFMANN
FirstName: MICHAEL
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 930 FRANKLIN ST SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014312
CountryCode: US
TelephoneNumber: 2565333388
FaxNumber: 2568016905
Practice Location
Address1: 930 FRANKLIN ST SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 35801
CountryCode: US
TelephoneNumber: 2565333388
FaxNumber: 2568016905
Other Information
ProviderEnumerationDate: 06/25/2008
LastUpdateDate: 08/23/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0001X37150ALY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

No ID Information.


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