Healthcare Provider Details

I. General information

NPI: 1235156951
Provider Name (Legal Business Name): NATIONAL CAPITAL FOOT & ANKLE CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 PARK POTOMAC AVE # R2
POTOMAC MD
20854-6973
US

IV. Provider business mailing address

12400 PARK POTOMAC AVE STE R2
POTOMAC MD
20854-7024
US

V. Phone/Fax

Practice location:
  • Phone: 301-983-8202
  • Fax: 877-810-5148
Mailing address:
  • Phone: 301-983-8202
  • Fax: 877-810-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO428
License Number StateDC

VIII. Authorized Official

Name: DR. FRANKLIN R POLUN
Title or Position: OWNER
Credential: DPM
Phone: 301-983-8201