Fedewa, Susan Therese
Fedewa, Susan Therese is an individual health care provider with primary practice located at 205 N East Ave , Jackson MI 49201-1753. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Fedewa, Susan Therese can be contacted via phone (517) 788-4800.Contact Information
Primary practice address
205 N East Ave
Jackson MI 49201-1753
Phone: (517) 788-4800
Fax: (517) 796-6410
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 5101010021 | Michigan |
Profile Details
| NPI number | 1750336004 |
|---|---|
| LBN Legal business name | Fedewa, Susan Therese |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2006 |
| Last updated | Nov 23rd, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750336004 | NPPES |
| Michigan | MEDICAID | 114873751 | |
| Michigan | Other | P00312682 |
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