Provider Demographics
NPI:1821016072
Name:SOHMER, AMY R (AA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:R
Last Name:SOHMER
Suffix:
Gender:F
Credentials:AA
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA
Mailing Address - Street 1:1364 CLIFTON RD
Mailing Address - Street 2:SUITE B-395
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-783-3195
Mailing Address - Fax:
Practice Address - Street 1:1364 CLIFTON RD
Practice Address - Street 2:SUITE B-395
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-783-3195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4654367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
19911AMedicare UPIN