Healthcare Provider Details

I. General information

NPI: 1275039125
Provider Name (Legal Business Name): HILA EICHENBAUM SELLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 HENDERSON MILL RD NE STE 108
ATLANTA GA
30345-2740
US

IV. Provider business mailing address

10084 REISTERSTOWN RD STE 200B
OWINGS MILLS MD
21117-4096
US

V. Phone/Fax

Practice location:
  • Phone: 770-239-2500
  • Fax: 404-745-8202
Mailing address:
  • Phone: 410-526-7993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number93411
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: