Provider Demographics
NPI:1609363282
Name:BENNETT, CARRIE DIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:DIANA
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FORBES TOWER
Mailing Address - Street 2:PLAZA LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:216-444-2200
Mailing Address - Fax:
Practice Address - Street 1:MAGEE WOMENS HOSPITAL OF UPMC
Practice Address - Street 2:300 MARKET STREET SUITE 0610
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-0001
Practice Address - Country:US
Practice Address - Phone:412-641-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMB476857207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program