Organization · Type 2 NPI

Tidalhealth Primary Care, LLC

Family Medicine Physician · Berlin, MD

NPI number 1699594960 Active

Practice location

9950 N Main St
Berlin, MD 21811-1076

Call (410) 912-6710 Map

Mailing address

PO Box 825474
Philadelphia, PA 19182-5474

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: 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.

Other family medicine physician providers in Berlin

See all in Berlin →

NPI record

NPI: 1699594960
Entity type: Organization (Type 2)
Issued: Oct 4, 2024
Last updated: Jul 22, 2025
Status: Active

Other names

<unavail>
Tidalhealth Primary Care · other name
Tidalhealth Primary Care · other name

Authorized official

William Pelot
Chief Administrator 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.

Is this your record? How to update it.

About NPI 1699594960

Tidalhealth Primary Care, LLC's National Provider Identifier is 1699594960, issued on Oct 4, 2024. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Berlin, MD. The record was last updated on Jul 22, 2025.