Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Susan Therese Fedewa, DO

Individual provider Emergency Medicine Physician · NPI 1750336004

Susan Therese Fedewa, DO is an Emergency Medicine in Jackson, Michigan. Qualified in 1987, 39 years ago. Practices with Legacy Physician Group PC, an 11-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
39
Licensed in
MI
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

205 N East Ave
Jackson, MI 49201-1753
Phone: (517) 788-4800
Fax: (517) 796-6410
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 5101010021 (MI)

Record details

NPI number1750336004
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 24, 2006
Last updated in NPPESNovember 23, 2007
Mailing addressDepartment 272801, Po Box 67000, Detroit, MI 48267-2728

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Legacy Physician Group Pc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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