Organization
TIDALHEALTH PHYSICIAN NETWORK, INC.
Active
Other names
TidalHealth Primary Care Laurel
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PELOT (CHIEF ADMINISTRATOR OFFICER)
(410) 543-7497
Entity
Organization
Contact information
Practice address
30549 SUSSEX HWY, LAUREL, DE 19956-3891
(302) 297-2579
Mailing address
PO BOX 824327, PHILADELPHIA, PA 19182-4327
(410) 912-6989
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
07/22/2025
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