Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bowie State University

Organization Phlebology Physician · NPI 1154888048

Bowie State University is a Phlebology Physician in Bowie, Maryland. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
4

Practice location Address checks out

14000 Jericho Park Road Henry Wise Wellness Center Cmrc Lowr Level
Bowie, MD 20715
Phone: (301) 860-4170
Fax: (601) 860-4179
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X
Phlebology Physician Taxonomy 202K00000X
Internal Medicine Physician Taxonomy 207R00000X
Obstetrics & Gynecology Nurse Practitioner Taxonomy 363LX0001X

Record details

NPI number1154888048
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBowie State University
Authorized official Artie Travis — Vice President Student Affairs · (301) 860-3390
Other names Henry Wise Wellness Center
NPI enumeratedFebruary 27, 2019
Last updated in NPPESFebruary 27, 2019
Mailing address14000 Jericho Park Road, Henry Wise Wellness Center, Cmrc, Lower Level, Bowie, MD 20715