Provider Demographics
NPI:1457358582
Name:PEARSE, CARLTON SHERMAN (MD)
Entity type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:SHERMAN
Last Name:PEARSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2720
Mailing Address - Country:US
Mailing Address - Phone:719-543-6755
Mailing Address - Fax:719-583-2236
Practice Address - Street 1:1501 COURT ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2720
Practice Address - Country:US
Practice Address - Phone:719-543-6755
Practice Address - Fax:719-583-2236
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMC-0297207V00000X
MOR9768207V00000X
COCDRH.0062723207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO20109104Medicaid
MOA13485Medicare UPIN
MO20109104Medicaid