NPI 1003042318

Beacon Medical Group, INC.

Organisation Family Medicine Physician Granger, IN

Practice location

Address: 12340 Bittersweet Commons Blvd W, Granger, IN 46530-6959
Phone: (574) 271-8610
Fax: (574) 271-8620
Mailing address: 710 N Niles Ave, South Bend, IN 46617-1924

Authorised official

Name: Jeffrey P Costello
Title: Cfo
Phone: (574) 647-3549

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Indiana →

Registry record

NPI: 1003042318
Entity type: Organization
NPI issued: 2 Jun 2009
Record last updated: 24 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.