| Nicholas Miller, | |
|
500 Arcade Ave Ste 210, Elkhart, IN 46514-2485 | |
| (574) 389-5656 | |
| (574) 523-7891 |
| Full Name | Nicholas Miller |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 500 Arcade Ave Ste 210, Elkhart, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164926515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 01089680A (Indiana) | Primary |
| Entity Name | Beacon Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Miller, 3245 Health Drive, Suite 100, Granger, IN 46530-1380 Ph: (574) 647-1840 | Nicholas Miller, 500 Arcade Ave Ste 210, Elkhart, IN 46514-2485 Ph: (574) 389-5656 |
Bradley Gordan, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 500 Arcade Ave Ste 320, Elkhart, IN 46514 Phone: 574-523-7900 Fax: 574-523-7909 | |
Luis Alfonso Benavente Chenhalls, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 500 Arcade Ave, Suite 340, Elkhart, IN 46514 Phone: 574-293-3317 Fax: 574-293-3523 | |
Anatoliy V. Rudin, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 500 Arcade Ave Ste 320, Elkhart, IN 46514 Phone: 574-293-3317 | |
Dr. Kelly R. Puster, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 303 S Nappanee St, Elkhart, IN 46514 Phone: 574-296-3220 Fax: 574-296-3322 | |
Dr. Colin Talanda Fath, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 500 Arcade Ave Ste 320, Elkhart, IN 46514 Phone: 574-523-7900 Fax: 574-523-7909 | |
Dr. Jamie Marie O'rear, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 500 Arcade Ave Ste 320, Elkhart, IN 46514 Phone: 574-523-7900 Fax: 574-523-7909 |