Provider Demographics
NPI:1497275515
Name:ROSENFIELD, SCOTT FRANCIS (IDC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:FRANCIS
Last Name:ROSENFIELD
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NAVAL SPECIAL WARFARE UNIT TWO
Mailing Address - Street 2:UNIT 30401
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09107-0401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NAVAL SPECIAL WARFARE UNIT TWO
Practice Address - Street 2:UNIT 30401
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09107-0401
Practice Address - Country:US
Practice Address - Phone:619-787-1569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman