| NPI | 1770954992 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P. COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208600000X Surgery | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2023-04-28 |