Amanda Boulos, is a
Physician Assistant based in Rydal, Georgia. Amanda Boulos is licensed to practice in * (Not Available) (license number ) and her current practice location is
4014 Highway 140, Rydal, Georgia. She can be reached at her office (for appointments etc.) via phone at
(678) 481-0579.
NPI number for Amanda Boulos is 1194503722 and her current mailing address is 4014 Highway 140, Rydal, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1194503722.
Provider's Profile
Full Name | Amanda Boulos |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 4014 Highway 140, Rydal, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1194503722
- Provider Enumeration Date: 09/15/2023
- Last Update Date: 09/15/2023
Medical Identifiers
Medical identifiers for Amanda Boulos such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194503722 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Boulos is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amanda Boulos, 4014 Highway 140, Rydal, GA 30171-1306 Ph: () - | Amanda Boulos, 4014 Highway 140, Rydal, GA 30171-1306 Ph: (678) 481-0579 |
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