Individual
IVY L FEDEWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 S STATE ST, BIG RAPIDS, MI 49307-1758
(231) 629-8665
Mailing address
203 S STATE ST, BIG RAPIDS, MI 49307-1758
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5501018286
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5501018286
—
MI
Enumeration date
12/18/2018
Last updated
10/31/2025
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