Sam Tellawi MD PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SAM TELLAWI MD PA

Practice address

560 Riverside Dr Ste A206
Salisbury, MD 21801-4704

Phone

(410) 912-5640

NPI assigned

Jan 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maria Cornman

Title

Manager

Phone

(800) 749-5191

Specialties & licenses 1

Addresses

Other identifiers 8

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1104963990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE",
            "address_2": "SUITE B-102",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351628",
            "telephone_number": "301-856-1960",
            "fax_number": "301-856-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 RIVERSIDE DR STE A206",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014704",
            "telephone_number": "410-912-5640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 Old Branch Ave",
            "address_2": "SUITE B-102",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MD",
            "postal_code": "207351628",
            "country_code": "US",
            "telephone_number": "301-856-1960",
            "fax_number": "301-856-3206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAM TELLAWI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "CORNMAN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "800-749-5191"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "062048700",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "1104963990",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "A618",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G02093",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "632104600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "8556",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "248N",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN4447",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Salisbury Physical Therapy & Sportsmedicine
• Salisbury Speech Therapy, LLC
• Salisbury University
• Salisbury Uro Surgery Center LLC
• Sallyboa Ventures LLC
• Sam'S Club Optical
• Hiba Sami, MBBS
• Sams East Inc
• Yashvir Sangwan, M.D
• Leslie Marie Santos-Roman, LGPC, CRC

• Gastroenterology Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Gastroenterology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.