PEDIATRIC SURGICAL ASSOCIATES P.A. NPI 1174640163

NPI Information

NPI: 1174640163
Provider Name: PEDIATRIC SURGICAL ASSOCIATES, P.A.
Classification: Surgery - 2086S0120X
Entity Type: Organization

Specialization: Pediatric Surgery

Address:
1900 RANDOLPH RD
STE 210
CHARLOTTE, NC
ZIP 28207
Phone: (704) 370-0223
Get Directions

PEDIATRIC SURGICAL ASSOCIATES, P.A. is a pediatric surgery surgery in Charlotte, NC. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. PEDIATRIC SURGICAL ASSOCIATES, P.A. NPI is 1174640163. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1900 RANDOLPH RD
STE 210
CHARLOTTE, NC
ZIP 28207-106
Phone: (704) 370-0223
Fax: (704) 370-0799

The provider's authorized official is Linda G. Boyd .
The authorized official title is Administrator and has the following contact phone number (704) 370-0223.

The enumeration date for this NPI number is 3/23/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0120X	Surgery	Pediatric Surgery	73120	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	890182W	MEDICAID	NORTH CAROLINA
2	NPA716	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »