Provider Demographics
NPI:1356544381
Name:MICHAEL P. STEWART, M.D.
Entity type:Organization
Organization Name:MICHAEL P. STEWART, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-345-1761
Mailing Address - Street 1:1011 W BALTIMORE PIKE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9446
Mailing Address - Country:US
Mailing Address - Phone:610-345-1761
Mailing Address - Fax:610-345-1762
Practice Address - Street 1:1011 W BALTIMORE PIKE
Practice Address - Street 2:SUITE 106
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9446
Practice Address - Country:US
Practice Address - Phone:610-345-1761
Practice Address - Fax:610-345-1762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018787E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009220910001Medicaid
PA1009220910001Medicaid