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TIDALHEALTH SPECIALTY CARE LLC NPI 1013532969


NPI Information

NPI: 1013532969
Provider Name: TIDALHEALTH SPECIALTY CARE, LLC

Other Name: TIDALHEALTH GASTROENTEROLOGY

Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 21D2023460

Address:
1640 WOODBROOKE DR
SALISBURY, MD
ZIP 21804
Phone: (410) 912-5640
Get Directions

TIDALHEALTH SPECIALTY CARE, LLC is a gastroenterology internal medicine in Salisbury, MD. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. TIDALHEALTH SPECIALTY CARE, LLC NPI is 1013532969. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Tidalhealth Gastroenterology.

The provider's business location address is:

1640 WOODBROOKE DR
SALISBURY, MD
ZIP 21804-501
Phone: (410) 912-5640

The provider's authorized official is Stephanie Gary .
The authorized official title is Cfo and has the following contact phone number (410) 912-6059.

The CLIA number assigned to this NPI record is 21D2023460 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2020 and was last updated on 2/28/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RG0100XInternal MedicineGastroenterologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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