Beacon Medical Group Mishawaka | |
5314 Lincolnway E Mishawaka IN 46544-4249 | |
(574) 584-2812 | |
(574) 584-2813 |
Full Name | Beacon Medical Group Mishawaka |
---|---|
Speciality | Family Medicine |
Location | 5314 Lincolnway E, Mishawaka, Indiana |
Authorized Official Name and Position | Jeffrey P Costello (CFO) |
Authorized Official Contact | 5746473549 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Beacon Medical Group Mishawaka 3245 Health Dr Ste 100 Granger IN 46530-1380 Ph: (574) 647-2129 | Beacon Medical Group Mishawaka 5314 Lincolnway E Mishawaka IN 46544-4249 Ph: (574) 584-2812 |
NPI Number | 1275550899 |
---|---|
Provider Enumeration Date | 07/17/2006 |
Last Update Date | 03/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275550899 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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