OrganizationActive
Beacon Medical Group, Inc.
NPI 1780856724 · Aerospace Medicine Physician · South Bend, IN
Provider details
- NPI number
- 1780856724
- Entity type
- Organization
- Primary specialty
- Aerospace Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Costello, Vp/Cfo(574) 647-3549
- License
- 71000502A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2301 N Bendix Dr
Suite 500
South Bend, IN 46628-3486
Phone: (574) 647-1675
Fax: (574) 232-5595
Approximate (ZIP-level) locationGet directions
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Other names (DBA / former)
- Doing business as
- Beacon Medical Group Occupational Health South Bend
Registry dates
- Enumerated
- 2008-03-31
- Last updated
- 2016-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.