| NPI | 1932468352 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP VASCULAR INTERVENTIONAL RADIOLOGY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P. COSTELLO CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2017-10-12 |