OrganizationActive
Beacon Medical Group, Inc.
NPI 1306899554 · Endocrinology, Diabetes & Metabolism Physician · Granger, IN
Provider details
- NPI number
- 1306899554
- Entity type
- Organization
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Jeffrey Costello, Vp-Cfo
Practice location
6913 N Main St Ste 100
Granger, IN 46530
Phone: (574) 647-6400
Fax: (574) 647-2951
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Registry dates
- Enumerated
- 2006-05-18
- Last updated
- 2019-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.