TIDALHEALTH SPECIALTY CARE, LLC (NPI# 1245855196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245855196 |
Entity Type | Organization |
Organization Name | TIDALHEALTH SPECIALTY CARE, LLC |
Practice Address |
1415 S Division St Ste A Salisbury MD 21804-7291 |
Mailing Address |
Po Box 2498 Salisbury MD 21802-2498 |
Practice Telephone | 4109127234 |
Practice Fax Number | 4105726890 |
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 | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
TidalHealth Endocrinology | 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 |
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 |
1053936906 | Tidalhealth Specialty Care, LLC | Internal Medicine | 314 Franklin Ave Ste 301, Berlin, MD 21811-1238 | 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 |
1415 S DIVISION ST STE A |
City | SALISBURY |
State | MD |
Zip Code | 21804-7291 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093907404 | Jack L Snitzer, D.o., P.a. | Internal Medicine | 1415 S Division St Ste A, Salisbury, MD 21804-7291 | 2007-08-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
Find all providers in zip 21804 |
Taxonomy Code | 207RE0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Endocrinology, Diabetes & Metabolism |
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
---|---|---|---|---|
1093907404 | Jack L Snitzer, D.o., P.a. | Internal Medicine | 1415 S Division St Ste A, Salisbury, MD 21804-7291 | 2007-08-10 |
1093719528 | Augustine Uchechukwu Obi | Internal Medicine | 611 Mocksville Ave, Salisbury, NC 28144-2705 | 2005-06-13 |
1154734507 | Juman Takeddin | Internal Medicine | 1415 S Division St, Salisbury, MD 21804 | 2014-06-03 |
1346677929 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 340 Jake Alexander Blvd W, Ste C, Salisbury, NC 28147-1364 | 2013-09-27 |
1073867594 | Carolinas Medical Center-northeast | Internal Medicine | 340 Jake Alexander Blvd W, Suite C, Salisbury, NC 28147-1364 | 2012-11-06 |
1033152103 | Jack L Snitzer | Internal Medicine | 1415 S Division St, Suite A, Salisbury, MD 21804-7232 | 2006-06-14 |
1215983564 | Michael J Sollenberger | Internal Medicine | 1601 Brenner Ave, Salisbury, NC 28144-2515 | 2006-05-26 |
1447236955 | Carey Robar | Internal Medicine | 611 Mocksville Ave, Salisbury, NC 28144-2731 | 2005-12-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477102309 | Lifebridge Suburban Physicians Group, LLC | Internal Medicine | 4 W Rolling Cross Road, Suite 100, Catonsville, MD 21228-6280 | 2019-09-04 |
1285282046 | Lee Scott Weinstein | Internal Medicine | 10 Center Drive Bldg 10 Rm8c101, Bethesda, MD 20892-0001 | 2019-08-26 |
1811453475 | Leila Shobab | Internal Medicine | 5514 Greentree Rd, Bethesda, MD 20817-3548 | 2019-02-19 |
1558825307 | Ideal Endocrinology LLC | Internal Medicine | 3000 Chestnut Ave Ste 202, Baltimore, MD 21211-2794 | 2019-01-25 |
1912475633 | Jocelyn Uriostegui | Internal Medicine | 108 Forbes St # 2, Annapolis, MD 21401-1502 | 2018-11-12 |
1104300334 | Johns Hopkins University | Internal Medicine | 1700 N Caroline St, Baltimore, MD 21213-2204 | 2018-09-24 |
1356857643 | Capital Diabetes & Endocrine Associates LLC | Internal Medicine | 5801 Allentown Rd Ste 500, Camp Springs, MD 20746-4518 | 2017-12-21 |
1427567163 | Phillip Gorden | Internal Medicine | 10 Center Dr Building 10/crc Room 6-5940, Bethesda, MD 20892-0001 | 2017-09-26 |
1366986739 | Maryland Medical Center, LLC | Internal Medicine | 8100 Sandpiper Cir Ste 100, Nottingham, MD 21236-5028 | 2016-12-05 |
1174079180 | Theresa Kehoe | Internal Medicine | 11712 Lovejoy St, Silver Spring, MD 20902-1637 | 2016-08-30 |
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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.