| Beacon Medical Group, Inc. | |
|
5314 Lincolnway E Mishawaka IN 46544-4249 | |
| (574) 584-2812 | |
| (574) 584-2813 |
| Full Name | Beacon Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 5314 Lincolnway E, Mishawaka, Indiana |
| Authorized Official Name and Position | Jeffrey P Costello (CFO) |
| Authorized Official Contact | 5746473549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Medical Group, Inc. 3245 Health Dr Ste 100 Granger IN 46530-1380 Ph: (574) 647-2129 | Beacon Medical Group, Inc. 5314 Lincolnway E Mishawaka IN 46544-4249 Ph: (574) 584-2812 |
| NPI Number | 1275550899 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 03/18/2026 |
| Certification Date | 03/18/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275550899 | NPI | - | NPPES |
| 300127345 | Medicaid | IN |
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