MEDICARE: TIDALHEALTH PRIMARY CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1134971807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIDALHEALTH PRIMARY CARE, LLC

Provider Business Mailing Address
First Line	:	560 RIVERSIDE DR STE B204
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21801-4703
Country	:	US
Telephone Number	:	410-543-7720
Fax Number	:	410-543-7721

Provider Business Practice Location Address
First Line	:	560 RIVERSIDE DR STE B204
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21801-4703
Country	:	US
Telephone Number	:	410-543-7720
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATOR OFFICER
Name	:	WILLIAM PELOT
Credential	:
Telephone Number	:	410-543-7497

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	07/22/2025

Similar Medicare Providers

1053314260 — RIVERSIDE NEUROLOGY ASSOCIATES, P.A.
Practice Location Address:

560 RIVERSIDE DR , STE B204
SALISBURY, MD
21801-4703

Practice Phone: 410-546-5722
Practice Fax: 410-546-5851

1386751659 — LYNN FRANCIS ASCHER DMD
Practice Location Address:

560 RIVERSIDE DRIVE SUITE B201
SALISBURY, MD
21801-4703

Practice Phone: 410-543-1675
Practice Fax: 410-543-1763

1225215924 — LYNN F ASCHER P A
Practice Location Address:

560 RIVERSIDE DRIVE , SUITE B201
SALISBURY, MD
21801-4703

Practice Phone: 410-543-1675
Practice Fax: 410-543-1763

1013496405 — RIVERSIDE NEUROLOGY LLC
Practice Location Address:

560 RIVERSIDE DR STE B204
SALISBURY, MD
21801-4703

Practice Phone: 410-546-5722
Practice Fax: 410-546-5851

1245710631 — RIVERSIDE NEUROLOGY ASSOCIATES LLC
Practice Location Address:

560 RIVERSIDE DR STE B204
SALISBURY, MD
21801-4703

Practice Phone: 410-546-5722
Practice Fax: 410-546-5851

1114784188 — TIDALHEALTH PRIMARY CARE, LLC
Practice Location Address:

560 RIVERSIDE DR STE B204
SALISBURY, MD
21801-4703

Practice Phone: 410-543-7720
Practice Fax:

Directions to “TIDALHEALTH PRIMARY CARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.