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General NPI Number Information
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NPI Number | 1003868449
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Entity Type | Individual
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Provider Name | LEE TAN WOLFE MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 222 N NEVADA AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907
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Country | US
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Telephone | 719-776-5142
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Fax | 719-776-5827
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Provider Business Mailing Address
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Address Line | 33 LONO AVE STE 305
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City | KAHULUI
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State | HI
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Zip | 96732-1635
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Country | US
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Telephone | 808-538-3232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 18225
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 42241
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01052930A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A86812
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD-24787
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License Number State | HI
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