MEDICARE: POLUN AMERICAN SURGERY CENTER, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP1100X	Podiatric Clinic/Center	A1127	MD

General Provider Information

NPI Number	:	1780687442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLUN AMERICAN SURGERY CENTER, PC

Provider Business Mailing Address
First Line	:	10236 RIVER RD
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-4959
Country	:	US
Telephone Number	:	301-983-9873
Fax Number	:	301-299-3985

Provider Business Practice Location Address
First Line	:	10236 RIVER RD
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-4959
Country	:	US
Telephone Number	:	301-983-9873
Fax Number	:	301-299-3985

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FRANKLIN R POLUN
Credential	:	DPM
Telephone Number	:	301-983-8202

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	10/05/2017

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