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Tidalhealth Peninsula Regional, Inc.

Organization Active NPI Family Medicine Physician · Salisbury, MD

NPI 1093672065 · NPPES record last updated Jan 9, 2026

Key facts

NPI
1093672065
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
TIDALHEALTH PENINSULA REGIONAL, INC.
Practice address
1639 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 912-5785
NPI assigned
Jan 9, 2026
Organization subpart
No

Authorized official

Name
Sloan Trammell
Title
Credentialing Manager
Phone
(410) 912-6989

Corporate family (same tax ID) 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Peninsula Regional Medical Center (33 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193200000X MULTI-SPECIALTY GROUP		 133V00000X
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

1639 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

PO Box 826880
Philadelphia, PA 19182-6880

Other providers in Salisbury, MD

All providers in Salisbury, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.