TIDALHEALTH SPECIALTY CARE, LLC (NPI# 1053936906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053936906 |
| Entity Type | Organization |
| Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
| Practice Address |
314 Franklin Ave Ste 301 Berlin MD 21811-1238 |
| Mailing Address |
Po Box 2498 Salisbury MD 21802-2498 |
| Practice Telephone | 4106291995 |
| Practice Fax Number | 4106291993 |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |
| Authorized Official Name | KARIN DIBARI (PRESIDENT) |
| Authorized Official Telephone | 6035772799 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| TidalHealth Cardiology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992320840 | Tidalhealth Specialty Care, LLC | Internal Medicine | 560 Riverside Dr Ste A106, Salisbury, MD 21801-4702 | 2020-06-16 |
| 1245855196 | Tidalhealth Specialty Care, LLC | Internal Medicine | 1415 S Division St Ste A, Salisbury, MD 21804-7291 | 2020-06-16 |
| 1487279337 | Tidalhealth Specialty Care, LLC | Neurological Surgery | 1630 Woodbrooke Dr, Salisbury, MD 21804-8501 | 2020-06-16 |
| 1952926891 | Tidalhealth Specialty Care, LLC | Pediatrics | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-16 |
| 1013532969 | Tidalhealth Specialty Care, LLC | Internal Medicine | 560 Riverside Dr Ste A206, Salisbury, MD 21801-4704 | 2020-06-16 |
| 1083239933 | Tidalhealth Specialty Care, LLC | Anesthesiology | 264 Tilghman Rd, Salisbury, MD 21804-1921 | 2020-06-16 |
| 1306461256 | Tidalhealth Specialty Care, LLC | Psychiatry & Neurology | 1630 Woodbrooke Dr, Salisbury, MD 21804-8501 | 2020-06-16 |
| 1962027094 | Tidalhealth Specialty Care, LLC | Clinic/Center | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-15 |
| 1679198642 | Tidalhealth Specialty Care, LLC | Internal Medicine | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-15 |
| 1124643184 | Tidalhealth Specialty Care, LLC | Internal Medicine | 100 E Carroll St, Salisbury, MD 21801-5422 | 2020-06-15 |
| Street Address |
314 FRANKLIN AVE STE 301 |
| City | BERLIN |
| State | MD |
| Zip Code | 21811-1238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295990570 | Abhishek Chandrakant Sawant | Internal Medicine | 314 Franklin Ave Ste 301, Berlin, MD 21811-1238 | 2008-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366912909 | Kathleen Cathell | Speech-Language Pathologist | 11187 Racetrack Rd, Berlin, MD 21811 | 2018-11-27 |
| 1033613336 | Kimberly Rose Richardson | Registered Nurse | Atlantic General Hospital, 9733 Healthway Dr, Berlin, MD 21811 | 2018-03-21 |
| 1780108514 | Jayme Sroka Mahoney | Marriage & Family Therapist | 124 N. Main St. Ste. C, Berlin, MD 21811 | 2017-08-02 |
| 1013332543 | Ray Charles Lockamy Jr. | Behavior Technician | 10514 Racetrack Rd Ste G, Berlin, MD 21811 | 2014-02-20 |
| 1972845121 | Timothy Pearson | Dermatology | 9948 N. Main St., Berlin, MD 21811 | 2013-03-25 |
| 1710248315 | Jaime Farrell Coates | Counselor | 378 Schooner Ln, Berlin, MD 21811 | 2012-05-31 |
| 1902185697 | Lee Ahlstrom | Pharmacist | 11307 Manklin Creek Rd, Berlin, MD 21811 | 2011-08-11 |
| 1780987677 | Worcester County Health Department | Public Health or Welfare | 107 Williams Street, Worcester County Health Department Dental Center, Berlin, MD 21811 | 2010-12-15 |
| 1942511563 | Corey Lee Smith | Dentist | 11204 Racetrack Rd Ste 102, Berlin, MD 21811 | 2010-06-29 |
| 1255656062 | Sarah Mae Brown | Pharmacist | Apple Discount Drugs 314 Franklin Avenue, Berlin, MD 21811 | 2010-04-05 |
| Find all providers in zip 21811 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598824658 | Saadat U Khan Md Pa | Internal Medicine | 213 High St, Saadat U Khan Md Prof Assn, Berlin, NH 03570 | 2006-12-06 |
| 1649562042 | Advocare, LLC | Internal Medicine | 175 Cross Keys Rd, Bldg. 300 A, Berlin, NJ 08009-9263 | 2011-05-04 |
| 1639474877 | Stellar Medical Group | Internal Medicine | 175 Cross Keys Rd, Suite 101a, Berlin, NJ 08009-9263 | 2011-01-19 |
| 1316171671 | Berlin Medical Assco | Internal Medicine | 175 Cross Keys Rd, 300a, Berlin, NJ 08009-9263 | 2009-05-14 |
| 1295998094 | Stefan Lischke | Internal Medicine | 130 Fisher Rd, Mob-a, Suite 2-1, Berlin, VT 05602-9516 | 2008-07-02 |
| 1093877730 | Joachim Georg Mueller | Internal Medicine | 130 Fisher Rd, Cardiology Mob-a Suite 2-1, Berlin, VT 05602-9516 | 2006-12-15 |
| 1790704401 | Mark Robert Heitzman | Internal Medicine | 130 Fisher Rd, Mob-a Suite 2-1, Berlin, VT 05602-9516 | 2006-07-19 |
| 1386663094 | Gregory J Macdonald | Internal Medicine | 130 Fisher Rd, Mob- A Suite 2-1, Berlin, VT 05602-9516 | 2006-07-19 |
| 1376562074 | Michael G. Hayes | Internal Medicine | 130 Fisher Rd, Mob-a Suite 2-1, Berlin, VT 05602-9516 | 2006-07-19 |
| 1124053681 | David M Elbaum | Internal Medicine | 175 Cross Keys Rd, 300a, Berlin, NJ 08009-9263 | 2006-07-12 |
| Find all providers in BERLIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.