Organization
BEACON MEDICAL GROUP, INC.
Active
Other names
Beacon Medical Group Specialists Main Suite 100
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY COSTELLO (VP-CFO)
(574) 647-3549
Entity
Organization
Contact information
Practice address
6913 N MAIN ST STE 100, GRANGER, IN 46530
(574) 647-6400
(574) 647-2951
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100224050D
—
IN
Enumeration date
05/18/2006
Last updated
12/09/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us