Individual
DR. DEREK JOHN LYSTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1380 S COLUMBIA RD, GRAND FORKS, ND 58201-4059
(701) 795-2000
(701) 795-2260
Mailing address
PO BOX 6002, GRAND FORKS, ND 58206-6002
(701) 780-5000
(701) 780-1942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11427
ND
Other
Enumeration date
05/29/2007
Last updated
06/10/2016
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