NPI | 1487038360 |
---|---|
Doing Business As | BEACON MEDICAL GROUP VEIN SPECIALISTS |
Entity Type | Organization |
Authorized Contact | JEFFREY P. COSTELLO CFO 574-647-3549 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
Enumeration Date | 2015-07-10 |
Last Update Date | 2017-10-12 |