Healthcare Provider Details

I. General information

NPI: 1851858104
Provider Name (Legal Business Name): NATIONAL CAPITAL FOOT & ANKLE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 WISCONSIN AVE NW STE 522
WASHINGTON DC
20016-4131
US

IV. Provider business mailing address

5100 WISCONSIN AVE NW STE 522
WASHINGTON DC
20016-4131
US

V. Phone/Fax

Practice location:
  • Phone: 202-966-0900
  • Fax: 202-966-0836
Mailing address:
  • Phone: 202-966-0900
  • Fax: 202-966-0836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANKLIN R POLUN
Title or Position: OWNER
Credential: DPM
Phone: 301-529-1575