1043304090 NPI number — MICHAEL KAUFMANN MD

Table of content: MICHAEL KAUFMANN MD (NPI 1043304090)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043304090 NPI number — MICHAEL KAUFMANN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAUFMANN
Provider First Name:
MICHAEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043304090
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5245 N COUNTY ROAD 600 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSBURG
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46112-9481
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-514-6985
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LILLY CORPORATE CENTER
Provider Second Line Business Practice Location Address:
639 SOUTH DELAWARE ST.
Provider Business Practice Location Address City Name:
INDIANAPOLIS, INDIANA
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46225-4622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
463-209-3115
Provider Business Practice Location Address Fax Number:
317-276-1733
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207PE0004X , with the licence number:  01053866A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 01053866 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200326480 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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