NPI 1689627812

Beacon Medical Group

Organisation Urology Physician South Bend, IN

Practice location

Address: 100 Navarre Pl Suite 4400, South Bend, IN 46601-1156
Phone: (574) 647-4535
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

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 01024987A (IN)

Other Urology providers in Indiana →

Registry record

NPI: 1689627812
Entity type: Organization
NPI issued: 18 May 2006
Record last updated: 9 Mar 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.