Healthcare Provider Details

I. General information

NPI: 1568446540
Provider Name (Legal Business Name): NICHOLAS PARON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 MCCARTY RD
SAGINAW MI
48603
US

IV. Provider business mailing address

7600 MCCARTY RD
SAGINAW MI
48603-9678
US

V. Phone/Fax

Practice location:
  • Phone: 989-792-6326
  • Fax:
Mailing address:
  • Phone: 989-792-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101258914
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number52724
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301072145
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: