Individual provider · Type 1 NPI
Amanda Boulos
Surgical Physician Assistant · Marietta, GA
NPI number
1194503722
Active
Practice location
1371 Church Street Ext NE, Suite 200
Marietta, GA 30060-7913
Mailing address
1551 Janmar Rd
Snellville, GA 30078-5606
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | None listed |
| Surgical Physician Assistant Primary | 363AS0400X | 12976 (GA) |
Surgical Physician Assistant: Definition to come...
4 other providers at this address
- Laboratory Corporation of America HoldingsClinical Medical Laboratory Marietta, GA NPI 1487898151
- Wellstar Kennestone Pediatric Associates, LLCPediatrics Physician Marietta, GA NPI 1083660682
- Andrew Kenneth Ostrowski, MDUrology Physician Marietta, GA NPI 1831505361
- Jason Lomboy, MDUrology Physician Marietta, GA NPI 1265843312
Other surgical physician assistant providers in Marietta
- Torey Charlise Davis-Bogan, SA-C, CSTSurgical Physician Assistant Marietta, GA NPI 1003455874
- Ionela Anca Turcin, PA-CSurgical Physician Assistant Marietta, GA NPI 1023964517
- Brandon Virdell King, CSA, CSFASurgical Physician Assistant Marietta, GA NPI 1033447313
- Po El Wenrick, PASurgical Physician Assistant Marietta, GA NPI 1083107718
- Paula Lorene Cutrona, PA-CSurgical Physician Assistant Marietta, GA NPI 1083765937
- Sara Stephano Adams, PA-CSurgical Physician Assistant Marietta, GA NPI 1124504675
- Henry Payton, PASurgical Physician Assistant Marietta, GA NPI 1164969192
- Dixie Mayberry, PASurgical Physician Assistant Marietta, GA NPI 1184098832
About NPI 1194503722
Amanda Boulos's National Provider Identifier is 1194503722, issued on Sep 15, 2023. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Marietta, GA. The record was last updated on Apr 28, 2025.