Provider Demographics
NPI:1851858104
Name:NATIONAL CAPITAL FOOT & ANKLE CENTER
Entity Type:Organization
Organization Name:NATIONAL CAPITAL FOOT & ANKLE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
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:301-529-1575
Mailing Address - Street 1:5100 WISCONSIN AVE NW STE 522
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4131
Mailing Address - Country:US
Mailing Address - Phone:202-966-0900
Mailing Address - Fax:202-966-0836
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:202-966-0900
Practice Address - Fax:202-966-0836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC012480037Medicaid