BEACON MEDICAL GROUP INC. NPI 1124423546

NPI Information

BEACON MEDICAL GROUP, INC. is a nephrology internal medicine in South Bend, IN. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. BEACON MEDICAL GROUP, INC. NPI is 1124423546. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 NAVARRE PL STE 4400
SOUTH BEND, IN
ZIP 46601-100
Phone: (574) 647-1972
Fax: (574) 647-1974

The provider's authorized official is Jeffrey P. Costello .
The authorized official title is Cfo and has the following contact phone number (574) 647-3549.

The enumeration date for this NPI number is 10/28/2014 and was last updated on 10/12/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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