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General NPI Number Information
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NPI Number | 1386171098
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Entity Type | Individual
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Provider Name | CHRISTINE ELISABETH KOLWITZ DO
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Gender | Female
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 201 CEDAR ST SE STE 820
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4912
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Country | US
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Telephone | 505-841-1434
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Fax | 505-222-2149
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PHS PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DO213250
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | DO2025-0003
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License Number State | NM
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