Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidalhealth Primary Care, LLC

Organization Family Medicine Physician · NPI 1699594960

Tidalhealth Primary Care, LLC provides Family Medicine Physician services in Berlin, Maryland. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9950 N Main St
Berlin, MD 21811-1076
Phone: (410) 912-6710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1699594960
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Pelot — Chief Administrator Officer · (410) 543-7497
Other names Tidalhealth Primary Care; Tidalhealth Primary Care
NPI enumeratedOctober 4, 2024
Last updated in NPPESJuly 22, 2025
Certification dateJuly 22, 2025
Mailing addressPo Box 825474, Philadelphia, PA 19182-5474

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