Provider Demographics
NPI:1932106077
Name:BATES, CARLTON
Entity Type:Individual
Prefix:
First Name:CARLTON
Middle Name:
Last Name:BATES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CARL
Other - Middle Name:M
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
Mailing Address - Street 2:4401 PENN AVENUE, RANGOS 5TH FLOOR, ROOM 5130
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
Practice Address - Street 2:4401 PENN AVENUE, RANGOS 5TH FLOOR, ROOM 5130
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201
Practice Address - Country:US
Practice Address - Phone:412-692-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4356472080P0210X
OH350635892080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2129137Medicaid
KY64963721OtherMEDICAID
WV6700122000OtherMEDICAID
G77366Medicare UPIN
OHBA0883401Medicare ID - Type Unspecified