Healthcare Provider Details

I. General information

NPI: 1922914050
Provider Name (Legal Business Name): CONTINUUM WOUND AND PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12513 WOODSONG LN
BOWIE MD
20721-4225
US

IV. Provider business mailing address

12513 WOODSONG LN
BOWIE MD
20721-4225
US

V. Phone/Fax

Practice location:
  • Phone: 256-417-7067
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BONAVENTURE MBELLA
Title or Position: OWNER
Credential:
Phone: 256-417-7067