| Tidalhealth Physician Network, Inc. | |
|
9111 Antique Aly Unit 1 Bridgeville DE 19933-4682 | |
| (302) 337-9320 | |
| Not Available |
| Full Name | Tidalhealth Physician Network, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 9111 Antique Aly Unit 1, Bridgeville, Delaware |
| Authorized Official Name and Position | William Pelot (CHIEF ADMINISTRATOR OFFICER) |
| Authorized Official Contact | 4105437497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidalhealth Physician Network, Inc. Po Box 824327 Philadelphia PA 19182-4327 Ph: (410) 912-6989 | Tidalhealth Physician Network, Inc. 9111 Antique Aly Unit 1 Bridgeville DE 19933-4682 Ph: (302) 337-9320 |
| NPI Number | 1639982952 |
|---|---|
| Provider Enumeration Date | 01/30/2025 |
| Last Update Date | 07/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639982952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Internal Medicine Of Bridgeville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8991 Redden Rd, Bridgeville, DE 19933 Phone: 302-337-3300 Fax: 302-337-8072 | |
Kenneth R Smith Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8991 Redden Rd, Bridgeville, DE 19933 Phone: 302-337-3300 Fax: 302-337-8072 |