Provider Demographics
NPI:1306873179
Name:ROSENFELD, KARL (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:
Last Name:ROSENFELD
Suffix:
Gender:M
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:PO BOX 968
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-644-7755
Mailing Address - Fax:610-644-8290
Practice Address - Street 1:254 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-644-7755
Practice Address - Fax:610-644-8290
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011098E207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA200033469OtherRAILROAD MEDICARE
DEG01550O02OtherMEDICARE OF DELAWARE
PA019539MKHMedicare PIN
PA200033469OtherRAILROAD MEDICARE