National Provider Identifier Database

DEREK A MCLISTER, D.P.M – NPI #1114453552
Podiatrist

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.


Contact Information

DEREK A MCLISTER, D.P.M
5225 23RD AVE S
FARGO, ND58104-7927
Phone: 701-417-2575
Fax:
Website:
Specialty Taxonomy Code
* Podiatrist 213E00000X
Foot and Ankle Surgery 207XX0004X
Student in an Organized Health Care Education/Training Program 390200000X

* Indicates primary specialty

NPI Profile & details for DEREK A MCLISTER

NPI Number 1114453552
Credentials D.P.M
Entity Individual
Enumeration date 05/04/2017
Last updated 04/04/2022 - About 4 years ago
Sole proprietor1 Yes
Identifiers
  • MN License #: 1068
  • ND License #: 86
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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