Provider Demographics
NPI:1801188891
Name:LIST, MARK D (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:LIST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-0900
Mailing Address - Country:US
Mailing Address - Phone:605-504-5400
Mailing Address - Fax:605-504-5150
Practice Address - Street 1:6215 SOUTH CLIFF AVENUE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8589
Practice Address - Country:US
Practice Address - Phone:605-322-3300
Practice Address - Fax:605-322-3301
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2022-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD9187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine