Basic Information
| Provider Information | |||||||||
| NPI: | 1679914436 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MPANDE | ||||||||
| FirstName: | CAROLINE | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1100 NEW JERSEY AVE SE STE 500 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200033326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022791817 | ||||||||
| FaxNumber: | 2026172985 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 NEW JERSEY AVE SE STE 500 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200033326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2022791817 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2013 | ||||||||
| LastUpdateDate: | 01/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 36.003785 | OH | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213E00000X | 8773747262 | NY | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213ES0131X | PO1000112 | DC | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
No ID Information.