Individual
ELLIE KELEPOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
216 N. BROAD ST., 5TH FLOOR, PHILADELPHIA, PA 19102
(215) 762-1147
(215) 762-1904
Mailing address
1601 CHERRY ST., SUITE 11511, PHILADELPHIA, PA 19102
(215) 255-7822
(215) 255-7825
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD038124L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008593700002
—
PA
Enumeration date
10/06/2005
Last updated
11/20/2018
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