MR. Andrew Kirby Gustavson, PA-C

NPI #1306571302 in Waxhaw, North Carolina

Provider Information

NPI Number: 1306571302
Entity Type: Individual
Name: MR. Andrew Kirby Gustavson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 22, 2022
Last Updated: Dec 28, 2022

Practice Location

Address: 3614 PROVIDENCE RD S STE 200
City: Waxhaw
State: North Carolina
ZIP Code: 28173-6310
Phone: (704) 384-8640

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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