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Organization
BEACON MEDICAL GROUP MICHIGAN INC
Active
Organization
BEACON MEDICAL GROUP MICHIGAN INC
Active
Other names
Beacon Medical Group Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE MAFFETONE (MANAGER CONTRACTING AND PAYOR RELAT)
(574) 647-1040
Entity
Organization
Contact information
Practice address
1717 SHAFFER ST, STE 124, KALAMAZOO, MI 49048-1647
(269) 344-5552
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-1820
(574) 647-1821
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
MI
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
NULL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
NULL
207RR0500X
Rheumatology Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085N0700X
Neuroradiology Physician
—
NULL
2085N0700X
Neuroradiology Physician
—
—
2086S0129X
Vascular Surgery Physician
—
NULL
2086S0129X
Vascular Surgery Physician
—
—
208800000X
Urology Physician
—
NULL
208800000X
Urology Physician
—
—
363LA2100X
Acute Care Nurse Practitioner
—
NULL
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/22/2006
Last updated
10/09/2026
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