Individual
DR. ETHAN S. ROSENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5295 S COMMERCE DR STE 550, MURRAY, UT 84107-4736
(801) 313-4110
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
D88188
MD
208600000X
Surgery Physician
MD047589
DC
2086S0129X
Vascular Surgery Physician
Primary
12792806-1205
UT
2086S0129X
Vascular Surgery Physician
MD2024-1035
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D88188
MD LICENSE
MD
01
—
MD047589
DC LICENSE
DC
01
—
MD2024-1035
NM LICENSE
NM
Enumeration date
05/16/2016
Last updated
12/31/2025
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