Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beacon Medical Group, Inc

Organization Family Medicine Physician · NPI 1205852365

Beacon Medical Group, Inc is a Family Medicine Physician in Edwardsburg, Michigan. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

27082 W Main St
Edwardsburg, MI 49112-9334
Phone: (269) 663-8288
Fax: (269) 663-2426
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 06-005017-1 (IN)

Record details

NPI number1205852365
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeff Costello — Cfo · (574) 647-3549
Other names Beacon Medical Group Edwardsburg; Beacon Medical Group Edwardsburg
NPI enumeratedJuly 14, 2006
Last updated in NPPESMay 3, 2023
Certification dateApril 24, 2023
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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