OrganizationActive
Beacon Medical Group, Inc.
NPI 1972831311 · Cardiovascular Disease Physician · Plymouth, IN
Provider details
- NPI number
- 1972831311
- Entity type
- Organization
- Primary specialty
- Cardiovascular Disease PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Jeffrey Costello, Vp/Cfo
- License
- 01061323A (IN)
Practice location
2855 Miller Dr
Suite 121
Plymouth, IN 46563-8091
Phone: (574) 647-1600
Fax: (574) 237-6069
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Registry dates
- Enumerated
- 2009-11-23
- 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.