MEDICARE: ANDREW S KAUFMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD60955940	WA
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD60955940	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548608524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW S KAUFMAN M.D.

Provider Business Mailing Address
First Line	:	710 S 49TH ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98408-5706
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9040 JACKSON AVE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-0004
Country	:	US
Telephone Number	:	539-681-1102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2013
Last Update Date	:	03/29/2024

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