Individual
ROGER NEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8555
Mailing address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8555
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
22699
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08-01177
MEDICA
MN
05
—
120660
—
MN
01
—
2712
AVERA
MN
01
—
40082
SIOUX VALLEY
MN
01
—
573R4NE
BCBS/MEDICARE SUPPLEMENT
MN
05
—
573R4NE
—
MN
05
—
584029
—
IA
01
—
763472
ARAZ
MN
01
—
MH9041000786
PPO
MN
Enumeration date
12/08/2005
Last updated
07/09/2007
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