Individual
HERBERT R. KAUFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
399 S BROADWAY ST, LAKE ORION, MI 48362-2740
(248) 338-5604
(734) 677-7407
Mailing address
PO BOX 1108, ATTN: BARB SIMMONS, ANN ARBOR, MI 48106-1108
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101005027
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1327210
—
MI
01
—
300F361250
BCBS GROUP PIN
MI
01
—
3156309204
BCBS PIN #
MI
01
—
CA3518
MEDICARE RR GROUP PIN
MI
Enumeration date
07/04/2006
Last updated
02/03/2011
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