| NPI | 1316073372 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP OBGYN RIVER OAKS LAWN AENUE |
| Doing Business As | BEACON MEDICAL GROUP OBSTETRICS & GYNECOLOGY ELKHART |
| Doing Business As | BEACON MEDICAL GROUP OBGYN RIVER OAKS |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IN 07-005017-1) |
| Additional Taxonomies | 367A00000X Advanced Practice Midwife |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2024-03-04 |