IndividualActive
Jeffrey Lystad, MD
NPI 1710904487 · Sports Medicine (Family Medicine) Physician · Fargo, ND
Provider details
- NPI number
- 1710904487
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 7448 (ND)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2301 25th St S
Fargo, ND 58103-6104
Phone: (701) 237-9712
Approximate (ZIP-level) locationGet directions
Mailing address
2301 25th St S
Fargo, ND 58103-6104
Registry dates
- Enumerated
- 2006-07-17
- Last updated
- 2011-11-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.