Provider Demographics
NPI:1982892774
Name:ROSENFELD, ADAM D (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:DO
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 652
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-0652
Mailing Address - Country:US
Mailing Address - Phone:765-599-3400
Mailing Address - Fax:765-599-3500
Practice Address - Street 1:2200 FOREST RIDGE PKWY.
Practice Address - Street 2:SUITE 310
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-2943
Practice Address - Country:US
Practice Address - Phone:765-599-3400
Practice Address - Fax:765-599-3500
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036120164207Q00000X
IN99041338A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200980990Medicaid
IN200980990Medicaid