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NPI Code Detail

MEDICARE: PARAGON HEALTH, P.C.

MEDICARE: PARAGON HEALTH, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207KI0005XClinical & Laboratory Immunology (Allergy & Immunology) PhysicianMI
2207K00000XAllergy & Immunology PhysicianMI
3207KA0200XAllergy PhysicianMI

General Provider Information

NPI Number : 1649234980
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARAGON HEALTH, P.C.
Provider Business Mailing Address
First Line : 430 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-5304
Country : US
Telephone Number : 269-321-6673
Fax Number : 269-324-5594
Provider Business Practice Location Address
First Line : 430 W CENTRE AVE
Second Line :
City : PORTAGE
State : MI
Zip : 49024-5304
Country : US
Telephone Number : 269-321-6673
Fax Number : 269-324-5594
Authorized Official
Title or Position : PRESIDENT
Name : MR. SANJAY P. DALAL
Credential : M.D.
Telephone Number : 269-341-4554
Provider Enumeration Date : 04/13/2006
Last Update Date : 03/06/2015

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Directions to “PARAGON HEALTH, P.C. ” Practice Location

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