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Organization

TIDALHEALTH SPECIALTY CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM PELOT (CHIEF ADMINISTRATIVE OFFICER)
(410) 546-7497
Entity
Organization

Contact information

Practice address
11107 CATHAGE RD UNIT 103, BERLIN, MD 21811-2155
(410) 912-5674
Mailing address
PO BOX 825461, PHILADELPHIA, PA 19182-5461

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Enumeration date
09/04/2025
Last updated
09/04/2025
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