Dr. Derek Anthony Mclister
Podiatrist Foot and Ankle Orthopaedic Surgeon
5225 23rd Ave S
Fargo
, North Dakota 58104-7927
Dr. Derek Anthony Mclister
Podiatrist Foot and Ankle Orthopaedic Surgeon
5225 23rd Ave S
Fargo
, North Dakota 58104-7927
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About
Features
Specialties
- Foot and Ankle Orthopaedic Surgeon
- Podiatrist
Languages spoken
- English
Location
First Address
- Dr. Derek Anthony Mclister
- Po Box 5074
- Sioux Falls, SD
- Zip : 57117-5074
- Phone :
Second Address
- Dr. Derek Anthony Mclister
- 5225 23rd Ave S
- Fargo, ND
- Zip : 58104-7927
- Phone : (701) 417-2575
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Is Dr. Derek Anthony Mclister a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 86 | ND |
| Y | 213E00000X | Podiatrist | 1068 | MN |
| Y | 222Z00000X | Podiatrist | 1068 | MN |
National Provider Identifier
| NPI | 1114453552 |
|---|---|
| Provider Name | Dr. Derek Anthony Mclister |
| First Address | Sioux Falls, SD 57117-5074 |
| Second Address | Fargo, ND 58104-7927 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/05/2017 |
| Last Update Date | 18/10/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.