Organization · Type 2 NPI

Tidalhealth Specialty Care, LLC

Surgery Physician · Salisbury, MD

NPI number 1417760604 Active

Practice location

800 S Salisbury Blvd Ste D
Salisbury, MD 21801-6266

Call (410) 543-6400 Map

Mailing address

PO Box 825461
Philadelphia, PA 19182-5461

Specialties and licenses

Taxonomy	Code	License
Surgery Physician Primary	208600000X	None listed

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

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NPI record

NPI: 1417760604
Entity type: Organization (Type 2)
Issued: Jan 30, 2025
Last updated: Jul 22, 2025
Status: Active

Other names

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Tidalhealth General Surgery · other name
Tidalhealth General Surgery · other name

Authorized official

William Pelot
Chief Administrative Officer
(410) 543-7497

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1417760604

Tidalhealth Specialty Care, LLC's National Provider Identifier is 1417760604, issued on Jan 30, 2025. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Salisbury, MD. The record was last updated on Jul 22, 2025.