Provider Demographics
NPI:1831372424
Name:CHIPROUT, ELLY (MD)
Entity type:Individual
Prefix:DR
First Name:ELLY
Middle Name:
Last Name:CHIPROUT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15 AVE 3
Mailing Address - Street 2:ESTANCIAS LOS ROSALES 111
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5600
Mailing Address - Country:US
Mailing Address - Phone:787-237-1051
Mailing Address - Fax:787-881-2568
Practice Address - Street 1:ROAD 628 KM 3.1
Practice Address - Street 2:SECTOR JOVALES SABANA HOYOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00628
Practice Address - Country:US
Practice Address - Phone:787-881-2617
Practice Address - Fax:787-881-2568
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR10861207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine