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Contact Information

BEACON MEDICAL GROUP, INC.
100 NAVARRE PL STE 4470
SOUTH BEND, IN46601-1168
 Phone: 574-647-1405
 Fax: 574-647-3970
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Women's Health

363LW0102X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BEACON MEDICAL GROUP INC · (Female)

NPI Number 1578862181
Status Active
Credentials
Entity Individual
Enumeration date 03/22/2011
Last updated 01/30/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers
  • IN Medicaid 201020740A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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