| NPI | 1558652347 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP SPECIALISTS BREMEN |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P. COSTELLO VP/CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001058A) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2016-08-30 |