Organization
PEDIATRIC SURGICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA G. BOYD (ADMINISTRATOR)
(704) 370-0223
Entity
Organization
Contact information
Practice address
1900 RANDOLPH RD, STE 210, CHARLOTTE, NC 28207-1106
(704) 370-0223
(704) 370-0799
Mailing address
1900 RANDOLPH RD, STE. 210, CHARLOTTE, NC 28207-1106
(704) 370-0223
(704) 370-0799
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
73120
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890182W
—
NC
05
—
NPA716
—
SC
Enumeration date
03/23/2007
Last updated
08/22/2020
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