Provider Demographics
NPI:1386147411
Name:NATIONAL CAPITAL FOOT AND ANKLE CENTER
Entity type:Organization
Organization Name:NATIONAL CAPITAL FOOT AND ANKLE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:POLUN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-983-8202
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 1:5100 WISCONSIN AVE NW STE 522
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4131
Practice Address - Country:US
Practice Address - Phone:202-306-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL CAPITAL FOOT AND ANKLE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-15
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric