Healthcare Provider Details

I. General information

NPI: 1982659389
Provider Name (Legal Business Name): SURGICAL ASSOCIATES OF FREDERICKSBURG, A DIVISION OF MAHA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SAM PERRY BLVD SUITE 211
FREDERICKSBURG VA
22401-4467
US

IV. Provider business mailing address

1101 SAM PERRY BLVD SUITE 211
FREDERICKSBURG VA
22401-4467
US

V. Phone/Fax

Practice location:
  • Phone: 540-373-2244
  • Fax: 540-371-4849
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: GREG KAUFFMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 540-374-3147