Provider Demographics
NPI:1972690873
Name:TELLALIAN-ADAMS, SARAH A (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:TELLALIAN-ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:330-626-4080
Mailing Address - Fax:330-626-5821
Practice Address - Street 1:1365 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4432
Practice Address - Country:US
Practice Address - Phone:330-342-5649
Practice Address - Fax:330-342-5651
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-070144208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHG68026Medicare UPIN
OHAD7257121Medicare ID - Type Unspecified
OH0568050Medicaid