Organization
PROHEALTH MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER GEISS, MD (PRESIDENT)
(262) 928-8669
Entity
Organization
Contact information
Practice address
20611 WATERTOWN RD, SUITE J, WAUKESHA, WI 53186-1871
(262) 928-5900
Mailing address
N17W24100 RIVERWOOD DR, SUITE 250, WAUKESHA, WI 53188-1177
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505180008
DME
WI
05
—
32652600
—
WI
Enumeration date
05/24/2011
Last updated
09/08/2021
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