MEDICARE: DR. STEVE VINCENT KAUFMANN D.O.

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	208000000X	Pediatrics Physician	5101013025	MI

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
2	11280103	OTHER		CAQH PROVIDER ID
3	3556910084	OTHER	MI	BCBSM
4	381303843	OTHER		TAX ID

General Provider Information

NPI Number	:	1790716470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVE VINCENT KAUFMANN D.O.

Provider Business Mailing Address
First Line	:	829 N CENTER AVE
Second Line	:	SUITE 298
City	:	GAYLORD
State	:	MI
Zip	:	49735-1595
Country	:	US
Telephone Number	:	989-731-7708
Fax Number	:	989-731-7929

Provider Business Practice Location Address
First Line	:	829 N CENTER AVE
Second Line	:	SUITE 130
City	:	GAYLORD
State	:	MI
Zip	:	49735-1595
Country	:	US
Telephone Number	:	989-731-7930
Fax Number	:	989-731-7948

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/15/2013

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Directions to “ DR. STEVE VINCENT KAUFMANN D.O.” Practice Location

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