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Tidalhealth Specialty Care, LLC

Surgery in Berlin, MD. Organization (NPI-2).

NPI number1124980271
StatusActive
Last updated in NPPESNov 26, 2025

Details

NPI
1124980271
Entity type
Organization (NPI-2)
Legal business name
Tidalhealth Specialty Care, LLC
Organization subpart
No
Enumeration date
Nov 26, 2025
Certification date
Nov 26, 2025
Last updated
Nov 26, 2025

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery––Yes

Practice location

10231 Old Ocean City Blvd Ste 207
Berlin, MD 21811-3568

Phone 410-641-9568

Mailing address

Po Box 825461
Philadelphia, PA 19182-5461

Authorized official

Sloan Trammell
Credentialing Manager
4109126989

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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