Healthcare Provider Details

I. General information

NPI: 1144325721
Provider Name (Legal Business Name): SELMA MEDICAL ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 SELMA DR
WINCHESTER VA
22601-3834
US

IV. Provider business mailing address

104 SELMA DR
WINCHESTER VA
22601-3834
US

V. Phone/Fax

Practice location:
  • Phone: 540-678-2800
  • Fax: 540-678-2849
Mailing address:
  • Phone: 540-678-2800
  • Fax: 540-678-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNA K EIRICH
Title or Position: PRESIDENT
Credential: MD
Phone: 540-678-2800