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Organization
JOHN SCOTT TIDBALL, MD, PC
Active
Organization
JOHN SCOTT TIDBALL, MD, PC
Active
Other names
Wildewood Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN SCOTT TIDBALL MD (OWNER)
(301) 737-7833
Entity
Organization
Contact information
Practice address
23415 THREE NOTCH RD, STE 2054 WILDEWOOD CTR, CALIFORNIA, MD 20619-4017
(301) 737-7833
(301) 737-4865
Mailing address
23415 THREE NOTCH RD, STE 2054 WILDEWOOD CTR, CALIFORNIA, MD 20619-4017
(301) 737-7833
(301) 737-4865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D52196
MD
Other
Enumeration date
11/24/2006
Last updated
04/04/2011
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