TIDALHEALTH PHYSICIAN NETWORK, INC.
NPI 1205649514
Family Medicine in Laurel, DE

Active since January 30, 2025
30549 SUSSEX HWY, LAUREL, DE 19956(302) 297-2579 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Tidalhealth Physician Network, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIDALHEALTH PHYSICIAN NETWORK, INC. (NPI 1205649514) is a healthcare organization registered as a family medicine in Laurel, Delaware and active in the NPI registry since January 2025. The organization lists William Pelot, Chief Administrator Officer, as its authorized official.

NPPES Registry Identity

NPI1205649514
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTIDALHEALTH PHYSICIAN NETWORK, INC.
Location Address30549 SUSSEX HWYLaurel, DE 19956-3891
Mailing AddressPo Box 824327Philadelphia, PA 19182-4327 · (410) 912-6989
Organization SubpartNo
Authorized OfficialWilliam PelotChief Administrator Officer · (410) 543-7497
Enumeration DateJanuary 30, 2025
Last NPPES UpdateJuly 22, 2025
NPPES CertifiedJuly 22, 2025
NPI 1205649514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

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.

30549 SUSSEX HWY, Laurel, DE 19956

Other Names 1

Other NameTidalhealth Primary Care Laurel

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
30549 SUSSEX HWY
LAUREL, DE 19956
Family Medicine
30549 SUSSEX HWY
LAUREL, DE 19956
Nurse Practitioner (Family)
30549 SUSSEX HWY
LAUREL, DE 19956
Nurse Practitioner (Family)
30549 SUSSEX HWY
LAUREL, DE 19956
Family Medicine
30549 SUSSEX HWY
LAUREL, DE 19956
Nurse Practitioner (Family)
30549 SUSSEX HWY
LAUREL, DE 19956

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205649514, enumerated as an "organization" on January 30, 2025.

The provider is located at 30549 SUSSEX HWY LAUREL, DE 19956 and the phone number is (302) 297-2579.

Family Medicine with taxonomy code 207Q00000X.