MEDICARE: MICHAEL STEWART D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OP61129447	WA
2	390200000X	Student in an Organized Health Care Education/Training Program		OR

General Provider Information

NPI Number	:	1053775767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL STEWART D.O.

Provider Business Mailing Address
First Line	:	1403 S GRAND BLVD STE 201S
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99203-2278
Country	:	US
Telephone Number	:	509-903-5061
Fax Number	:	800-283-1969

Provider Business Practice Location Address
First Line	:	1403 S GRAND BLVD STE 201S
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99203-2278
Country	:	US
Telephone Number	:	509-903-5061
Fax Number	:	800-283-1969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2016
Last Update Date	:	01/12/2026

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