TIDALHEALTH PHYSICIAN NETWORK, INC.; NPI #1811732514

Contact Information

TIDALHEALTH PHYSICIAN NETWORK, INC.

11105 CATHAGE RD
BERLIN, MD 21811-2131

Phone: 410-912-4934
Fax: 410-912-5934
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oncology	261QX0200X

Indicates primary specialty

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NPI Profile & details for TIDALHEALTH PHYSICIAN NETWORK, INC.

NPI Number	`1811732514`
LBN Legal business name	TIDALHEALTH PHYSICIAN NETWORK, INC.
Authorized official	WILLIAM PELOT - (CHIEF ADMINISTRATOR OFFICER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	06/26/2024
Last updated	07/22/2025 - About 11 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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TIDALHEALTH PHYSICIAN NETWORK, INC.

Contact Information

Specialty

Oncology

NPI Profile & details for TIDALHEALTH PHYSICIAN NETWORK, INC.

Reviews for TIDALHEALTH PHYSICIAN NETWORK, INC.