OrganizationActive
Beacon Medical Group, Inc.
NPI 1831149525 · Orthopaedic Surgery Physician · South Bend, IN
Provider details
- NPI number
- 1831149525
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Costello, Vp-Cfo(574) 647-3549
- License
- 01055773A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
100 Navarre Pl Ste 5500
South Bend, IN 46601-1172
Phone: (574) 647-5300
Fax: (574) 647-5305
Approximate (ZIP-level) locationGet directions
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Registry dates
- Enumerated
- 2006-05-11
- Last updated
- 2017-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.