| Beacon Medical Group Portage Road | |
|
3575 Portage Ave South Bend IN 46628-6092 | |
| (574) 647-4530 | |
| Not Available |
| Full Name | Beacon Medical Group Portage Road |
|---|---|
| Speciality | Family Medicine |
| Location | 3575 Portage Ave, South Bend, Indiana |
| Authorized Official Name and Position | Jeffrey Costello (VP-CFO) |
| Authorized Official Contact | 5746473549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Medical Group Portage Road 53842 Generations Dr South Bend IN 46635-1543 Ph: () - | Beacon Medical Group Portage Road 3575 Portage Ave South Bend IN 46628-6092 Ph: (574) 647-4530 |
| NPI Number | 1568413359 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 09/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568413359 | NPI | - | NPPES |
| 100092700B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01054535A (Indiana) | Primary |
Ronald E Grow Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 W Indiana Ave, South Bend, IN 46613 Phone: 574-289-5049 Fax: 574-288-0840 | |
Physician Management Services Of Indiana Ii, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 S Saint Louis Blvd Ste 204, South Bend, IN 46617 Phone: 888-829-8550 | |
Mcdonald Physical Therapy Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1005 N Hickory Rd, South Bend, IN 46615 Phone: 574-233-5754 Fax: 574-233-7406 | |
South Bend Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 N Eddy St, South Bend, IN 46617 Phone: 574-299-2450 Fax: 574-299-2415 | |
Uthman Cavallo, Md, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 53800 Generations Dr, South Bend, IN 46635 Phone: 574-273-3880 Fax: 574-271-0918 | |
Bendix Family Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 N Bendix Dr, South Bend, IN 46628 Phone: 574-245-4980 Fax: 574-245-4981 | |
Beacon Medical Group Ireland Road Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1815 E Ireland Rd, South Bend, IN 46614 Phone: 574-647-1700 Fax: 574-291-3351 |