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Beacon Medical Group, INC.

Internal Medicine, Sleep Medicine in Elkhart, IN. Organization (NPI-2).

NPI number1881925188
StatusActive
Last updated in NPPESMay 5, 2023

Details

NPI
1881925188
Entity type
Organization (NPI-2)
Legal business name
Beacon Medical Group, INC.
Organization subpart
No
Enumeration date
Jan 26, 2010
Certification date
May 5, 2023
Last updated
May 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RS0012X Internal Medicine, Sleep Medicine––Yes

Other names

  • Beacon Medical Group Sleep Medicine (Doing Business As)
  • Beacon Medical Group Sleep Medicine Elkhart East (Doing Business As)

Practice location

525 W Bristol St
Elkhart, IN 46514-2964

Phone 574-262-0239 · Fax 574-262-8391

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice locations

3301 County Road 6 East
Elkhart, IN 46514-7673

Phone 574-264-9635 · Fax 574-262-0398

Authorized official

Jeffrey P Costello
Cfo
5746473549

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