Healthcare Provider Details

I. General information

NPI: 1811920580
Provider Name (Legal Business Name): KIMBERLY S KAUFFMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MOUNT HOPE AVE SUITE 480
BANGOR ME
04401-5691
US

IV. Provider business mailing address

700 MOUNT HOPE AVE SUITE 480
BANGOR ME
04401-5691
US

V. Phone/Fax

Practice location:
  • Phone: 207-990-1615
  • Fax: 207-990-5997
Mailing address:
  • Phone: 207-990-1615
  • Fax: 207-990-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number014712
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: