| Evenstar Internal Medicine Pc | |
|
6165 Lehman Dr Ste 105 Colorado Springs CO 80918-5405 | |
| (719) 528-6929 | |
| (719) 528-6900 |
| Full Name | Evenstar Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6165 Lehman Dr Ste 105, Colorado Springs, Colorado |
| Authorized Official Name and Position | Trudy G Wong (PRESIDENT) |
| Authorized Official Contact | 7195286929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evenstar Internal Medicine Pc 6165 Lehman Dr Ste 105 Colorado Springs CO 80918-5405 Ph: (719) 528-6929 | Evenstar Internal Medicine Pc 6165 Lehman Dr Ste 105 Colorado Springs CO 80918-5405 Ph: (719) 528-6929 |
| NPI Number | 1396967097 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396967097 | NPI | - | NPPES |
| 15874273 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 34645 (Colorado) | Primary |
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