Healthcare Provider Details
I. General information
NPI: 1932106077
Provider Name (Legal Business Name): CARLTON BATES
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2005
Last Update Date: 05/28/2021
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UPMC CHILDREN'S HOSPITAL OF PITTSBURGH 4401 PENN AVENUE, RANGOS 5TH FLOOR, ROOM 5130
PITTSBURGH PA
15201
US
IV. Provider business mailing address
UPMC CHILDREN'S HOSPITAL OF PITTSBURGH 4401 PENN AVENUE, RANGOS 5TH FLOOR, ROOM 5130
PITTSBURGH PA
15201
US
V. Phone/Fax
- Phone: 412-692-9440
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0210X |
| Taxonomy | Pediatric Nephrology Physician |
| License Number | MD435647 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: