Organization
TIDALHEALTH SPECIALTY CARE, LLC
Active
Other names
TidalHealth Geriatrics
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PELOT (CHIEF ADMINISTRATIVE OFFICER)
(410) 543-7497
Entity
Organization
Contact information
Practice address
560 RIVERSIDE DR STE B204, SALISBURY, MD 21801-4703
(410) 912-6793
Mailing address
PO BOX 825461, PHILADELPHIA, PA 19182-5461
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
07/22/2025
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