Healthcare Provider Details

I. General information

NPI: 1306873179
Provider Name (Legal Business Name): KARL ROSENFELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 W LANCASTER AVE
PAOLI PA
19301
US

IV. Provider business mailing address

PO BOX 968
PAOLI PA
19301
US

V. Phone/Fax

Practice location:
  • Phone: 610-644-7755
  • Fax: 610-644-8290
Mailing address:
  • Phone: 610-644-7755
  • Fax: 610-644-8290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD011098E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: