Provider Demographics
NPI:1841416575
Name:GRIPPER, SOMMER NIKISHIA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SOMMER
Middle Name:NIKISHIA
Last Name:GRIPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOMMER
Other - Middle Name:NIKISHIA
Other - Last Name:GRIPPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6162 TIMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2117
Mailing Address - Country:US
Mailing Address - Phone:336-456-1844
Mailing Address - Fax:
Practice Address - Street 1:1825 EASTCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2301
Practice Address - Country:US
Practice Address - Phone:718-920-2267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY257 246207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine