Provider Demographics
NPI:1023034907
Name:POZARNY, EDWARD S (DPM)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:S
Last Name:POZARNY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S CARLIN SPRINGS RD
Mailing Address - Street 2:SUITE 512
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204
Mailing Address - Country:US
Mailing Address - Phone:703-820-1472
Mailing Address - Fax:703-820-3173
Practice Address - Street 1:611 S CARLIN SPRINGS RD
Practice Address - Street 2:SUITE 512
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204
Practice Address - Country:US
Practice Address - Phone:703-820-1472
Practice Address - Fax:703-820-3173
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000662213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2533-0003OtherBCBS DC
464442A14Medicare ID - Type Unspecified
T31251Medicare UPIN