| NPI | 1861421141 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP NORTH CENTRAL NEUROSURGERY ELKHART |
| Doing Business As | BEACON MEDICAL GROUP NEUROLOGY |
| Doing Business As | BEACON MEDICAL GROUP NEUROSURGERY MISHAWAKA |
| Doing Business As | BEACON MEDICAL GROUP NORTH CENTRAL NEUROSURGERY SOUTH BEND |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P COSTELLO VP/CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-10-11 |