# TIDALHEALTH PRIMARY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TidalHealth Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760201032
- **Authorized official:** WILLIAM PELOT (CHIEF ADMINISTRATOR OFFICER)
- **Authorized official phone:** (410) 543-7497

## Contact information

- **Practice address:** 30265 COMMERCE DR UNIT 206, MILLSBORO, DE 19966-3595
- **Practice address phone:** (302) 732-8400
- **Mailing address:** PO BOX 825474, PHILADELPHIA, PA 19182-5474
- **Mailing address phone:** (410) 912-6989
- **Mailing address fax:** (410) 912-4972

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2024
- **Last updated:** 07/22/2025