| Tidalhealth Primary Care, Llc | |
|
11101 Cathage Rd Unit 102 Berlin MD 21811-2115 | |
| (410) 912-6104 | |
| Not Available |
| Full Name | Tidalhealth Primary Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11101 Cathage Rd Unit 102, Berlin, Maryland |
| Authorized Official Name and Position | Stephanie Gary (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 4109126059 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidalhealth Primary Care, Llc Po Box 825474 Philadelphia PA 19182-5474 Ph: (410) 912-6989 | Tidalhealth Primary Care, Llc 11101 Cathage Rd Unit 102 Berlin MD 21811-2115 Ph: (410) 912-6104 |
| NPI Number | 1538988811 |
|---|---|
| Provider Enumeration Date | 10/04/2024 |
| Last Update Date | 10/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538988811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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