| NPI | 1972831311 |
|---|---|
| Doing Business As | BEACON MEDICAL GROUP SPECIALISTS PLYMOUTH |
| Entity Type | Organization |
| Authorized Contact | JEFFREY P COSTELLO VP/CFO 574-647-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 01045628A) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: IN 01061323A) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2016-08-30 |