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Beacon Medical Group — NPI 1689627812, South Bend, IN | NPI Central

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NPI 1689627812

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Beacon Medical Group

NPI 1689627812 · Urology Physician · South Bend, IN

Provider details

NPI number: 1689627812
Entity type: Organization
Primary specialty: Urology PhysicianAllopathic & Osteopathic Physicians
Organization subpart: No
Authorized official: Jeffrey Costello, Vp-Cfo(574) 647-3549
License: 01024987A (IN)

Specialties & taxonomies

Urology PhysicianPrimary208800000XLicense 01024987A (IN)
Allopathic & Osteopathic Physicians

Practice location

100 Navarre Pl

Suite 4400

South Bend, IN 46601-1156

Phone: (574) 647-4535

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

710 N Niles Ave

South Bend, IN 46617-1924

Other names (DBA / former)

Doing business as: Memorial Children'S Hospital Navarre Pediatrics

Registry dates

Enumerated: 2006-05-18
Last updated: 2016-03-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.