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Beacon Medical Group, INC.

Internal Medicine, Cardiovascular Disease in Three Rivers, MI. Organization (NPI-2).

NPI number1437574530
StatusActive
Last updated in NPPESApr 24, 2023

Details

NPI
1437574530
Entity type
Organization (NPI-2)
Legal business name
Beacon Medical Group, INC.
Organization subpart
No
Enumeration date
Feb 26, 2014
Certification date
Apr 24, 2023
Last updated
Apr 24, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RC0000X Internal Medicine, Cardiovascular Disease––Yes
207Y00000X Otolaryngology––

Other names

  • Beacon Medical Group Three Rivers Specialty Clinic (Doing Business As)

Practice location

711 S Health Parkway
Three Rivers, MI 49093-9387

Phone 269-273-9698 · Fax 269-273-9699

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924

Phone 574-647-1610

Authorized official

Jeffrey P. Costello
Cfo
5746473549

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