Beacon Medical Group Michigan INC
Family Medicine in Portage, MI. Organization (NPI-2).
NPI number1497709869
StatusActive
Last updated in NPPESOct 9, 2026
Details
- NPI
- 1497709869
- Entity type
- Organization (NPI-2)
- Legal business name
- Beacon Medical Group Michigan INC
- Organization subpart
- No
- Enumeration date
- May 20, 2006
- Certification date
- Oct 9, 2026
- Last updated
- Oct 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – | |
| 207RC0000X | Internal Medicine, Cardiovascular Disease | – | – | |
| 207RG0300X | Internal Medicine, Geriatric Medicine | – | – | |
| 207RI0011X | Internal Medicine, Interventional Cardiology | – | – | |
| 207VG0400X | Obstetrics & Gynecology, Gynecology | – | – | |
| 208000000X | Pediatrics | – | – | |
| 208600000X | Surgery | – | – | |
| 208D00000X | General Practice | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Other names
- Beacon Medical Group Michigan (Doing Business As)
Practice location
7901 Angling RdPortage, MI 49024-0714
Phone 269-552-2912 · Fax 269-552-2835
Mailing address
3245 Health Dr Ste 100Ste 100
Granger, IN 46530-1380
Phone 574-647-1820 · Fax 574-647-1821
Other practice locations
1555 E Chicago Rd
Sturgis, MI 49091-1993
Sturgis, MI 49091-1993
Phone 269-651-3218 · Fax 269-651-3219
633 S Erie St
Three Rivers, MI 49093-2073
Three Rivers, MI 49093-2073
Phone 269-273-9539
Authorized official
Irene Maffetone
Manager Contracting And Payor Relat
5746471040
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