Provider Demographics
NPI:1194786459
Name:KAUFMAN, CAROL H (MD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:H
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TABERNACLE RD.
Mailing Address - Street 2:JULIAN F. KEITH ALCOHOL AND DRUG ABUSE TREATMENT CENTER
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-2526
Mailing Address - Country:US
Mailing Address - Phone:828-257-6242
Mailing Address - Fax:
Practice Address - Street 1:201 TABERNACLE RD
Practice Address - Street 2:JULIAN F. KEITH ALCOHOL AND DRUG ABUSE TREATMENT CENTER
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-2526
Practice Address - Country:US
Practice Address - Phone:828-257-6242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25338207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8901209Medicaid
NC8901209Medicaid
NC202629CMedicare PIN