Provider Demographics
NPI:1235156951
Name:NATIONAL CAPITAL FOOT & ANKLE CENTER, PC
Entity Type:Organization
Organization Name:NATIONAL CAPITAL FOOT & ANKLE CENTER, PC
Other - Org Name:NATIONAL CAPITAL FOOT & ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
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:301-983-8201
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 # R2
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-6973
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:2006-07-17
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO428213E00000X
261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1264710001Medicare NSC
DC619856Medicare PIN
DC480022882Medicare PIN