Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Surgical Associates, PA

Organization Pediatric Surgery Physician · NPI 1174640163

Pediatric Surgical Associates, PA is a Pediatric Surgery Physician in Charlotte, North Carolina. Licensed in North Carolina. Registered with an NPI since 2007.

Licensed in
NC
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1900 Randolph Rd Ste 210
Charlotte, NC 28207-1106
Phone: (704) 370-0223
Fax: (704) 370-0799
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Surgery Physician (primary) Taxonomy 2086S0120X · Licence 73120 (NC)

Record details

NPI number1174640163
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Linda Boyd — Administrator · (704) 370-0223
NPI enumeratedMarch 23, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1900 Randolph Rd, Ste. 210, Charlotte, NC 28207-1106

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