| Susan Therese Fedewa, DO | |
|
205 N East Ave, Jackson, MI 49201-1753 | |
| (517) 788-4800 | |
| (517) 796-6410 |
| Full Name | Susan Therese Fedewa |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Experience | 38 Years |
| Location | 205 N East Ave, Jackson, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750336004 | NPI | - | NPPES |
| 114873751 | Medicaid | MI | |
| P00312682 | Other | MI | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101010021 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Edward W Sparrow Hospital | Lansing, MI | Hospital |
| Mclaren Greater Lansing | Lansing, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Legacy Physician Group Pc | 0648277830 | 8 |
| Entity Name | Kalamazoo Emergency Associates, Plc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942251244 PECOS PAC ID: 5890685473 Enrollment ID: O20040317001078 |
| Entity Name | Legacy Physician Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801800719 PECOS PAC ID: 0648277830 Enrollment ID: O20061101000048 |
| Entity Name | Emergency Professionals Of Michigan Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952740656 PECOS PAC ID: 3274767371 Enrollment ID: O20131003000093 |
| Entity Name | Ecs Central Michigan Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043711930 PECOS PAC ID: 9931462132 Enrollment ID: O20180423001965 |
| Entity Name | Hillsdale Emergency Physicians, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669018206 PECOS PAC ID: 0648605766 Enrollment ID: O20200120000752 |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Therese Fedewa, DO Department 272801, Po Box 67000, Detroit, MI 48267-2728 Ph: (517) 841-6913 | Susan Therese Fedewa, DO 205 N East Ave, Jackson, MI 49201-1753 Ph: (517) 788-4800 |
Jonathan F. Bradley, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 Fax: 517-796-6410 | |
Ross Warren Kynast, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 Fax: 248-893-6952 | |
Kevin Killian, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 | |
Deepa S Macha, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4996 Fax: 517-796-6410 | |
Dr. Gregory W Fuller, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1006 Airport Rd, Jackson, MI 49202 Phone: 517-784-6663 Fax: 517-787-7976 | |
Jared Tippett, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 | |
Dr. Brett Mcknight Russell, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 |