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BEACON MEDICAL GROUP, INC.

Vascular & Interventional Radiology

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.

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Contact Information

BEACON MEDICAL GROUP, INC.
621 MEMORIAL DR STE 312
SOUTH BEND, IN  46601-1073
 Phone: 574-647-5200
 Fax: 574-647-5210
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Vascular & Interventional Radiology

 2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for BEACON MEDICAL GROUP, INC.

NPI # 1932468352
LBN Legal business name BEACON MEDICAL GROUP, INC.
Authorized official JEFFREY COSTELLO - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/04/2012
Last updated 10/12/2017 - About 9 years ago
Identifiers
IN Medicaid 201063130A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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