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General NPI Number Information
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NPI Number | 1457358582
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Entity Type | Individual
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Provider Name | CARLTON SHERMAN PEARSE M.D
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1501 COURT ST
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City | PUEBLO
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State | CO
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Zip | 81003-2720
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Country | US
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Telephone | 719-543-6755
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Fax | 719-583-2236
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Provider Business Mailing Address
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Address Line | 1501 COURT ST
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City | PUEBLO
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State | CO
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Zip | 81003-2720
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Country | US
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Telephone | 719-543-6755
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Fax | 719-583-2236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MC-0297
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R9768
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | CDRH.0062723
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License Number State | CO
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