TIDALHEALTH PHYSICIAN NETWORK, INC. – NPI #1811732514
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents.

Health Care Provider Taxonomy Code for Clinic/Center

TIDALHEALTH PHYSICIAN NETWORK, INC. is an AHC clinic located in BERLIN, MD. NPPES has assigned the NPI number 1811732514 to TIDALHEALTH PHYSICIAN NETWORK, INC. on June 26, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QX0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Oncology

The NPI profile was last updated on Jul 22, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TIDALHEALTH PHYSICIAN NETWORK, INC. below.

NPI Profile for
TIDALHEALTH PHYSICIAN NETWORK, INC.

NPI Number
1811732514
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
TIDALHEALTH PHYSICIAN NETWORK, INC.
Primary location
11105 CATHAGE RD
BERLIN, MD 21811-2131
Phone: (410) 912-4934 Fax: (410) 912-5934
Mailing address
PO BOX 824327
PHILADELPHIA, PA 19182-4327
Phone: (410) 912-6989 Fax: (410) 912-4972
Organization Subpart
No
Authorized Official
WILLIAM PELOT
CHIEF ADMINISTRATOR OFFICER
Phone: (410) 543-7497
Updated
Certification Date
Jul 22, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QX0200X
- Clinic/Center / Oncology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.