Provider Demographics
NPI:1104455575
Name:CHILUPE, GEORGE KABWE (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:KABWE
Last Name:CHILUPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CUTTINO RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-2667
Mailing Address - Country:US
Mailing Address - Phone:803-778-2442
Mailing Address - Fax:
Practice Address - Street 1:30 CUTTINO RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2667
Practice Address - Country:US
Practice Address - Phone:803-778-2442
Practice Address - Fax:803-778-0880
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.017400207Q00000X
SCLL90005207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine