| NPI | 1114784188 |
|---|---|
| Other Name | TIDALHEALRH FAMILY MEDICINE PRACTICE |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GARY Vice President Finance 410-912-4976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-03-05 |
| Last Update Date | 2024-03-05 |