Healthcare Provider Details

I. General information

NPI: 1245397074
Provider Name (Legal Business Name): MICHELLE L. STEWART DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE L LANDIS DO

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 W NEWPORT RD
LITITZ PA
17543-7774
US

IV. Provider business mailing address

6 W NEWPORT RD
LITITZ PA
17543-7774
US

V. Phone/Fax

Practice location:
  • Phone: 717-331-5864
  • Fax: 717-723-4360
Mailing address:
  • Phone: 717-627-2108
  • Fax: 717-723-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS012676
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: