Healthcare Provider Details

I. General information

NPI: 1366435232
Provider Name (Legal Business Name): ROBERT GUIDO MICHELINI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 YORKTOWN RD
LEWISBERRY PA
17339-9258
US

IV. Provider business mailing address

7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

V. Phone/Fax

Practice location:
  • Phone: 717-932-4050
  • Fax: 717-932-8072
Mailing address:
  • Phone: 570-837-2123
  • Fax: 570-837-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS006157L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: