Provider Demographics
NPI:1386006674
Name:LEWIS, MICHELLE (DO)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 OLEAN ST STE 120
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2531
Mailing Address - Country:US
Mailing Address - Phone:716-458-1954
Mailing Address - Fax:
Practice Address - Street 1:94 OLEAN ST STE 120
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2531
Practice Address - Country:US
Practice Address - Phone:716-458-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322782-01207V00000X
OH34.015511207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology