Provider Demographics
NPI:1679914436
Name:MPANDE, CAROLINE N (DPM)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:N
Last Name:MPANDE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NEW JERSEY AVE SE STE 500
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3326
Mailing Address - Country:US
Mailing Address - Phone:202-279-1817
Mailing Address - Fax:202-617-2985
Practice Address - Street 1:1100 NEW JERSEY AVE SE STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3326
Practice Address - Country:US
Practice Address - Phone:202-279-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003785213E00000X
NY8773747262213E00000X
DCPO1000112213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist