Individual
RUSSELL ANDREW KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(701) 364-8000
(701) 364-8078
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-8000
(701) 364-8078
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11293
MN
363A00000X
Physician Assistant
1981
AK
363A00000X
Physician Assistant
Primary
PAC0411
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71034
—
ND
05
—
71305
—
ND
Enumeration date
08/22/2008
Last updated
03/02/2015
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