Individual
CAITLIN BROOKE TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2350
(803) 791-2520
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
51266
SC
207P00000X
Emergency Medicine Physician
LL51266
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
512663
—
SC
Enumeration date
07/21/2017
Last updated
08/04/2025
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