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Organization
PROHEALTH MEDICAL GROUP INC
Active
Organization
PROHEALTH MEDICAL GROUP INC
Active
Parent organization
PROHEALTH MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROHEALTH MEDICAL GROUP INC
Authorized official
PETER GEISS, MD (PRESIDENT)
(262) 928-8669
Entity
Organization
Contact information
Practice address
N57W24950 N CORPORATE CIR, SUSSEX, WI 53089-4383
(262) 820-3093
Mailing address
N17W24100 RIVERWOOD DR, SUITE 250, WAUKESHA, WI 53188-1177
(262) 928-4100
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505180002
DME
WI
05
—
32652600
—
WI
Enumeration date
05/24/2011
Last updated
05/23/2022
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