Healthcare Provider Details

I. General information

NPI: 1548229446
Provider Name (Legal Business Name): PETER N KAUFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 02/09/2021
Certification Date: 02/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10215 FERNWOOD RD SUITE 404
BETHESDA MD
20817-1106
US

IV. Provider business mailing address

10770 COLUMBIA PIKE STE 400
SILVER SPRING MD
20901-4462
US

V. Phone/Fax

Practice location:
  • Phone: 301-493-5210
  • Fax: 301-493-5479
Mailing address:
  • Phone: 240-485-5210
  • Fax: 301-654-2986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0038831
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: