Mclister, Derek Anthony

Mclister, Derek Anthony is an sole proprietor health care provider with primary practice located at 5225 23Rd Ave S , Fargo ND 58104-7927. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Foot and Ankle Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Mclister, Derek Anthony can be contacted via phone (701) 417-2575.

Contact Information

Primary practice address
5225 23Rd Ave S Fargo ND 58104-7927
Phone: (701) 417-2575
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Foot and Ankle Surgery 207XX0004X 86 North Dakota
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X North Dakota
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1068 Minnesota

Profile Details

NPI number 1114453552
LBN Legal business name Mclister, Derek Anthony
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2017
Last updated Apr 4th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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