Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 1996
NPI: 1932190642
Practice Locations (2)
TIDALHEALTH SPECIALTY CARE LLC
100 E CARROLL ST
SALISBURY, MD 218015422
TIDALHEALTH SPECIALTY CARE LLC
145 E CARROLL ST, SUITE B102
SALISBURY, MD 218015454
4109126172
Source: CMS National Downloadable File, September 2026.