Amanda Graefin Von Der Schulenburg, PA-C
Physician Assistant, Surgical in Atlanta, GA. Individual provider (NPI-1).
NPI number1619951985
StatusActive
Last updated in NPPESOct 1, 2009
Details
- NPI
- 1619951985
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Amanda Graefin Von Der Schulenburg
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 1, 2005
- Last updated
- Oct 1, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 003997 | GA | Yes |
| 363A00000X | Physician Assistant | 003997 | GA |
Other names
- Amanda Loris Wilson (Former Name)
Practice location
5673 Peachtree Dunwoody RdSuite 870
Atlanta, GA 30342
Phone 404-255-2975 · Fax 404-255-2276
Mailing address
5673 Peachtree Dunwoody RdSuite 870
Atlanta, GA 30342
Phone 404-255-2975 · Fax 404-255-2276
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