| NPI | 1639196249 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP-ELKHART EAST |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RN0300X Internal Medicine, Nephrology | |
| 207X00000X Orthopaedic Surgery | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-02-05 |