National Provider Identifier Database

TIDALHEALTH PHYSICIAN NETWORK INC
Oncology

An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents.


Contact Information

TIDALHEALTH PHYSICIAN NETWORK, INC.
11105 CATHAGE RD
BERLIN, MD21811-2131
Phone: 410-912-4934
Fax: 410-912-5934
Website:
Specialty Taxonomy Code
* Oncology 261QX0200X

* Indicates primary specialty

NPI Profile & details for TIDALHEALTH PHYSICIAN NETWORK, INC.

NPI Number 1811732514
Legal business name
LBN
TIDALHEALTH PHYSICIAN NETWORK, INC.
Authorized official WILLIAM PELOT - (CHIEF ADMINISTRATOR OFFICER)
Entity Organization
Organization subpart No
Enumeration date 06/26/2024
Last updated 07/22/2025 - About 11 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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