Provider Demographics
NPI:1609160142
Name:WEINTHALER, ANDREA MARIE (PA- C)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:WEINTHALER
Suffix:
Gender:F
Credentials:PA- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4790
Mailing Address - Country:US
Mailing Address - Phone:404-255-1930
Mailing Address - Fax:404-459-8510
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD STE 1000
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4790
Practice Address - Country:US
Practice Address - Phone:404-255-1930
Practice Address - Fax:404-459-8510
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006017363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant