Provider Demographics
NPI:1437217122
Name:ROSENFIELD, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:ROSENFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 US HIGHWAY 23 N
Mailing Address - Street 2:SUITE E
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8960
Mailing Address - Country:US
Mailing Address - Phone:740-363-5755
Mailing Address - Fax:740-363-3117
Practice Address - Street 1:1201 US HIGHWAY 23 N
Practice Address - Street 2:SUITE E
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-8960
Practice Address - Country:US
Practice Address - Phone:740-363-5755
Practice Address - Fax:740-363-3117
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-04-4856-R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0426364Medicaid