BEACON MEDICAL GROUP NPI 1689627812

NPI Information

BEACON MEDICAL GROUP is an urology in South Bend, IN. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. BEACON MEDICAL GROUP NPI is 1689627812. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Memorial Children's Hospital Navarre Pediatrics.

The provider's business location address is:

100 NAVARRE PL
SUITE 4400
SOUTH BEND, IN
ZIP 46601-156
Phone: (574) 647-4535

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

The CLIA number assigned to this NPI record is 15D2257554 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 3/9/2016.

Taxonomy Codes

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Other Identifiers

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