Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Andrew Kirby Gustavson, PA-C

Individual provider Physician Assistant · NPI 1306571302

Mr. Andrew Kirby Gustavson, PA-C is a Physician Assistant in Waxhaw, North Carolina. Qualified in 2022, 4 years ago. Practices with Urology Specialists of the Carolinas PLLC, a 75-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3614 Providence Rd S Ste 200
Waxhaw, NC 28173-6310
Phone: (704) 384-8640
Fax: (704) 384-8650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2682 Court Dr Ste B, Gastonia, NC 28054-1442 — (704) 824-0500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-12435 (NC)

Record details

NPI number1306571302
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 22, 2022
Last updated in NPPESDecember 28, 2022
Certification dateDecember 28, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Urology Specialists Of The Carolinas Pllc — 75 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Waxhaw