Organization · Type 2 NPI

Beacon Medical Group, Inc.

Vascular & Interventional Radiology Physician · Granger, IN

NPI number 1487038360 Active

Practice location

233 Florence Ave
Granger, IN 46530-8048

Call (574) 647-3990 Map

Fax (574) 647-3995

Mailing address

710 E Niles Ave
South Bend, IN 46617-1924

Specialties and licenses

Taxonomy	Code	License
Vascular & Interventional Radiology Physician Primary	2085R0204X	None listed

Vascular & Interventional Radiology Physician: A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

NPI record

NPI: 1487038360
Entity type: Organization (Type 2)
Issued: Jul 10, 2015
Last updated: Oct 12, 2017
Status: Active
Subpart: Yes of Beacon Health System, Inc.

Other names

<unavail>
Beacon Medical Group Vein Specialists · doing business as

Authorized official

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

Verify this record

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.

Is this your record? How to update it.

About NPI 1487038360

Beacon Medical Group, Inc.'s National Provider Identifier is 1487038360, issued on Jul 10, 2015. The primary taxonomy on file is Vascular & Interventional Radiology Physician (2085R0204X), and the practice location is in Granger, IN. The record was last updated on Oct 12, 2017.