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
BRIAN T LIPMAN MD (PRESIDENT CLINIC DIVISION)
(262) 928-8669
Entity
Organization
Contact information
Practice address
N16W24131 RIVERWOOD DR, WAUKESHA, WI 53188-1106
(262) 696-0808
Mailing address
725 AMERICAN AVE, MEDICAL STAFF OFFICE, WAUKESHA, WI 53188-5031
(262) 928-3270
(262) 953-8723
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505180015
DME
WI
Enumeration date
06/05/2006
Last updated
05/23/2022
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