Organization
TIDALHEALTH PHYSICIAN NETWORK, INC.
Active
Other names
TidalHealth Immediate Care
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PELOT (CHIEF ADMINISTRATOR OFFICER)
(410) 543-7497
Entity
Organization
Contact information
Practice address
8472 HERRING RUN RD UNIT A, SEAFORD, DE 19973-5763
(302) 297-2511
Mailing address
PO BOX 824327, PHILADELPHIA, PA 19182-4327
(410) 912-6053
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
07/22/2025
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