TIDALHEALTH PHYSICIAN NETWORK INC. NPI 1154134484

NPI Information

  • NPI: 1154134484
  • Provider Name: TIDALHEALTH PHYSICIAN NETWORK, INC.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 08D1024366
  • Address: 38552 SUSSEX HWY UNIT 101
    DELMAR, DE
    ZIP 19940
  • Phone: (302) 297-2583

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NPI Details

TIDALHEALTH PHYSICIAN NETWORK, INC. is a family medicine in Delmar, DE. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TIDALHEALTH PHYSICIAN NETWORK, INC. NPI is 1154134484. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

38552 SUSSEX HWY UNIT 101
DELMAR, DE
ZIP 19940-596
Phone: (302) 297-2583

The provider's authorized official is Denise W Jester .
The authorized official title is Director Accounting and has the following contact phone number (302) 629-6611.

The CLIA number assigned to this NPI record is 08D1024366 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2025 and was last updated on 1/30/2025.

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
1207Q00000XFamily MedicineYes

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: 3/30/2025

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