Individual
DR. VIKISHA TYESE FRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2104
(202) 448-4080
(202) 448-4082
Mailing address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2104
(202) 448-4080
(202) 448-4082
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
057460
GA
208200000X
Plastic Surgery Physician
057460
GA
208200000X
Plastic Surgery Physician
Primary
MD039256
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057460
GA MEDICAL LICENSE
GA
05
—
MD039256
—
DC
Enumeration date
06/11/2006
Last updated
05/30/2014
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