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General NPI Number Information
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NPI Number | 1174527113
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Entity Type | Individual
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Provider Name | BRUCE ROSENFELD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 225 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-481-3556
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Fax | 757-819-7762
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Provider Business Mailing Address
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Address Line | 225 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-481-3556
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Fax | 757-819-7762
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036172624
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 0101251295
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License Number State | VA
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