Provider Demographics
NPI:1568714061
Name:CHOI, AMANDA ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:ANN
Last Name:CHOI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:ANN
Other - Last Name:SCHAPPELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:240 E BELLE ISLE RD NE
Mailing Address - Street 2:APT 222
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2392
Mailing Address - Country:US
Mailing Address - Phone:610-451-4803
Mailing Address - Fax:
Practice Address - Street 1:4800 OLDE TOWNE PKWY STE 150A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4357
Practice Address - Country:US
Practice Address - Phone:770-509-1025
Practice Address - Fax:770-509-1884
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085004476363A00000X
GA007132363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant