| NPI | 1437574530 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP THREE RIVERS SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P. COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2023-04-24 |