Provider Demographics
NPI:1841254430
Name:PARAGON HEALTH, P.C.
Entity type:Organization
Organization Name:PARAGON HEALTH, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DALAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-341-4554
Mailing Address - Street 1:1535 GULL RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1650
Mailing Address - Country:US
Mailing Address - Phone:269-385-9900
Mailing Address - Fax:269-385-2140
Practice Address - Street 1:1535 GULL RD
Practice Address - Street 2:SUITE 105
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1650
Practice Address - Country:US
Practice Address - Phone:269-385-9900
Practice Address - Fax:269-385-2140
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARAGON HEALTH, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-12
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI100C910330OtherBCBSM
MI5904521OtherAETNA
MI5904521OtherAETNA
MIC13914Medicare UPIN