| NPI | 1295745503 |
|---|---|
| Doing Business As | TIDEWATER PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | SILVIA A DIAZ President 410-822-6712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |