Healthcare Provider Details

I. General information

NPI: 1598699522
Provider Name (Legal Business Name): MENDWELL MID-ATLANTIC WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 ANGLESEY DR
DAVIDSONVILLE MD
21035-1264
US

IV. Provider business mailing address

1314 ANGLESEY DR
DAVIDSONVILLE MD
21035-1264
US

V. Phone/Fax

Practice location:
  • Phone: 443-692-2070
  • Fax: 443-281-5650
Mailing address:
  • Phone: 443-692-2070
  • Fax: 443-281-5650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NIKHILESH AGARWAL
Title or Position: OWNER
Credential:
Phone: 717-332-7990