| NPI | 1881925188 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP SLEEP MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine Sleep Medicine |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2023-05-05 |