Provider Demographics
NPI:1194909945
Name:NATIONAL CAPITAL FOOT & ANKLE CENTER, PC
Entity type:Organization
Organization Name:NATIONAL CAPITAL FOOT & ANKLE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:POLUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:202-966-0900
Mailing Address - Street 1:12400 PARK POTOMAC AVE STE R2
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-7024
Mailing Address - Country:US
Mailing Address - Phone:301-983-8202
Mailing Address - Fax:877-810-5148
Practice Address - Street 1:12400 PARK POTOMAC AVE STE R2
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854
Practice Address - Country:US
Practice Address - Phone:301-983-8202
Practice Address - Fax:877-810-5148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213ES0103X
DCPO1000050332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1301870001Medicare NSC
MDT31059Medicare UPIN