Healthcare Provider Details

I. General information

NPI: 1902847098
Provider Name (Legal Business Name): PARAGON HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 01/12/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 OLD CENTRE RD
PORTAGE MI
49024-4883
US

IV. Provider business mailing address

3000 OLD CENTRE RD
PORTAGE MI
49024-4883
US

V. Phone/Fax

Practice location:
  • Phone: 269-321-7546
  • Fax: 269-321-1705
Mailing address:
  • Phone: 269-321-7546
  • Fax: 269-321-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK C. RUMMEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 269-341-4554