Provider Demographics
NPI:1629528765
Name:PARAGON HEALTH, P.C.
Entity Type:Organization
Organization Name:PARAGON HEALTH, P.C.
Other - Org Name:WEST MICHIGAN PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-341-4554
Mailing Address - Street 1:8175 CREEKSIDE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5370
Mailing Address - Country:US
Mailing Address - Phone:269-222-1611
Mailing Address - Fax:269-222-1607
Practice Address - Street 1:8175 CREEKSIDE DR STE 100
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5370
Practice Address - Country:US
Practice Address - Phone:269-222-1611
Practice Address - Fax:269-222-1607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAGON HEALTH, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-13
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010699042086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty