Individual
MARK A TIDSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
759 CHESTNUT STREET, S2668, SPRINGFIELD, MA 01199
(413) 794-5439
(413) 794-5389
Mailing address
280 CHESTNUT STREET, 2ND FLOOR, SPRINGFIELD, MA 01199
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
161219
MA
207RP1001X
Pulmonary Disease Physician
161219
MA
Other
Enumeration date
05/30/2006
Last updated
04/01/2011
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