Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD435647 | PA |
NPI | 1932106077 |
---|---|
Provider Name | Carlton Bates |
First Address | Pittsburgh, PA 15201 |
Second Address | Pittsburgh, PA 15201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 28/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G77366 | (02) |