Beacon Medical Group, Inc.
NPI #1124423546 in South Bend, Indiana
Provider Information
- NPI Number
- 1124423546
- Entity Type
- Organization
- Organization Name
- Beacon Medical Group, Inc.
- Primary Specialty
- Internal Medicine - Nephrology
- Enumeration Date
- Oct 28, 2014
- Last Updated
- Oct 12, 2017
Practice Location
- Address
- 100 NAVARRE PL STE 4400
- City
- South Bend
- State
- Indiana
- ZIP Code
- 46601-1100
- Phone
- (574) 647-1972
Authorized Official
- Name
- JEFFREY P. COSTELLO
- Title
- CFO
- Phone
- (574) 647-3549
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Nephrology — Nephrology |
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