Organization
TIDALHEALTH SPECIALTY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SLOAN TRAMMELL (CREDENTIALING MANAGER)
(410) 912-6989
Entity
Organization
Contact information
Practice address
10614 RACETRACK RD UNIT 5, BERLIN, MD 21811-3383
(410) 629-1450
Mailing address
PO BOX 825461, PHILADELPHIA, PA 19182-5461
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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