TIDALHEALTH PRIMARY CARE LLC NPI 1760201032

NPI Information

  • NPI: 1760201032
  • Provider Name: TIDALHEALTH PRIMARY CARE, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • :
  • Address: 30265 COMMERCE DR UNIT 206
    MILLSBORO, DE
    ZIP 19966
  • Phone: (302) 732-8400

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NPI Details

TIDALHEALTH PRIMARY CARE, LLC is a family medicine in Millsboro, 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 PRIMARY CARE, LLC NPI is 1760201032. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

30265 COMMERCE DR UNIT 206
MILLSBORO, DE
ZIP 19966-595
Phone: (302) 732-8400

The provider's authorized official is William Pelot .
The authorized official title is Chief Administrator Officer and has the following contact phone number (410) 543-7497.

The enumeration date for this NPI number is 10/4/2024 and was last updated on 7/22/2025.

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?

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This page was last updated on: 11/21/2025

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