TIDALHEALTH SPECIALTY CARE, LLC – NPI #1710849872
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Health Care Provider Taxonomy Code for Radiology

TIDALHEALTH SPECIALTY CARE, LLC is a radiologist located in BERLIN, MD. NPPES has assigned the NPI number 1710849872 to TIDALHEALTH SPECIALTY CARE, LLC on November 26, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was last updated on Dec 29, 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 SPECIALTY CARE, LLC below.

NPI Profile for
TIDALHEALTH SPECIALTY CARE, LLC

NPI Number
1710849872
Enumeration Date

(about 6 months 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 SPECIALTY CARE, LLC
Primary location
10614 RACETRACK RD UNIT 4
BERLIN, MD 21811-3383
Phone: (443) 728-1090 Fax:
Mailing address
PO BOX 825461
PHILADELPHIA, PA 19182-5461
Phone: Fax:
Organization Subpart
No
Authorized Official
SLOAN TRAMMELL
CREDENTIALING MANAGER
Phone: (410) 912-6989
Updated
Certification Date
Dec 29, 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
2085R0202X
- Radiology / Diagnostic Radiology (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.