Provider Demographics
NPI:1518959253
Name:ADAMS-FERGUSON, KAREN MOTELLER (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MOTELLER
Last Name:ADAMS-FERGUSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 WEXFORD CT
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1366
Mailing Address - Country:US
Mailing Address - Phone:419-865-5078
Mailing Address - Fax:
Practice Address - Street 1:4895 MONROE ST
Practice Address - Street 2:SUITE 203
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4383
Practice Address - Country:US
Practice Address - Phone:419-471-9000
Practice Address - Fax:419-471-0705
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053089207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0673392Medicaid
OH0673392Medicaid