Organization
EVENSTAR INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRUDY G WONG MD (PRESIDENT)
(719) 528-6929
Entity
Organization
Contact information
Practice address
6165 LEHMAN DR STE 105, COLORADO SPRINGS, CO 80918-5405
(719) 528-6929
(719) 528-6900
Mailing address
6165 LEHMAN DR STE 105, COLORADO SPRINGS, CO 80918-5405
(719) 528-6929
(719) 528-6900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34645
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15874273
—
CO
Enumeration date
05/03/2007
Last updated
08/22/2020
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