| NPI | 1578862181 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP MIDWIFERY CENTERED CARE SOUTH BEND |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P COSTELLO VP/CFO 574-647-3549 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 367A00000X Advanced Practice Midwife |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2025-01-30 |