NPI 1124071246

Beacon Medical Group INC

Organisation Obstetrics & Gynecology Physician South Bend, IN

Practice location

Address: 100 Navarre Pl Suite 4470, South Bend, IN 46601-1156
Phone: (574) 647-4230
Mailing address: 710 N Niles Ave, South Bend, IN 46617-1924

Authorised official

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

Registered specialties

Obstetrics & Gynecology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207V00000X Licence 01027434A (IN)

Other Obstetrics & Gynecology providers in Indiana →

Registry record

NPI: 1124071246
Entity type: Organization
NPI issued: 18 May 2006
Record last updated: 30 Aug 2016

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.