Organization · Type 2 NPI

Beacon Medical Group, Inc.

Family Medicine Physician · Middlebury, IN

NPI number 1114363835 Active

Practice location

206 W Warren St
Middlebury, IN 46540-9410

Call (574) 825-2146 Map

Fax (574) 524-7435

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Family Nurse Practitioner	363LF0000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5 other providers at this address

Other family medicine physician providers in Middlebury

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NPI record

NPI: 1114363835
Entity type: Organization (Type 2)
Issued: May 21, 2013
Last updated: Mar 4, 2024
Status: Active

Other names

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Beacon Medical Group Middlebury · doing business as
Beacon Medical Group Middlebury · doing business as

Authorized official

Mr. Jeffrey P. Costello
CFO
(574) 647-3549

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114363835

Beacon Medical Group, Inc.'s National Provider Identifier is 1114363835, issued on May 21, 2013. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Middlebury, IN. The record was last updated on Mar 4, 2024.