Individual provider · Type 1 NPI

Michelle Louise Tidd, PA

Physician Assistant · Charlotte, NC

NPI number 1194126813 Active

Practice location

1918 Randolph Rd Ste 130
Charlotte, NC 28207-1107

Call (704) 316-6005 Map

Fax (704) 316-6006

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice locations

  • 840 Pine St, Ste 500, Macon, GA 31201-2100 · (478) 633-8682
  • 449 N Wendover Rd Ste A, Charlotte, NC 28211-1064 · (704) 316-6005

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant 363AS0400X2865 (SC)
Physician Assistant Primary 363A00000X0010-11355 (NC)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1194126813

Michelle Louise Tidd, PA's National Provider Identifier is 1194126813, issued on Sep 12, 2014. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Charlotte, NC. The record was last updated on Aug 26, 2025.