Individual
SHAI D ROSENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4104 SE 82ND AVE, STE 250, PORTLAND, OR 97266-2954
(503) 215-9850
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD1666004
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500666194
—
OR
Enumeration date
05/17/2012
Last updated
02/26/2014
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