# TIDALHEALTH PENINSULA REGIONAL, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649137613
- **Authorized official:** SLOAN TRAMMELL (CREDENTIALING MANAGER)
- **Authorized official phone:** (410) 912-6989

## Contact information

- **Practice address:** 201 HALL HWY, CRISFIELD, MD 21817-1237
- **Practice address phone:** (410) 968-1200
- **Mailing address:** PO BOX 826880, PHILADELPHIA, PA 19182-6880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2026
- **Last updated:** 01/09/2026