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Individual
DR. DEREK ANTHONY MCLISTER
Active
Individual
DR. DEREK ANTHONY MCLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
86
ND
213E00000X
Podiatrist
Primary
1068
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
ND
Other
Enumeration date
05/04/2017
Last updated
04/04/2022
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