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
240 W. MAPLE AVENUE, MUKWONAGO, WI 53149-8475
(262) 928-1900
(262) 928-1949
Mailing address
N17W24100 RIVERWOOD DRIVE, SUITE 250, WAUKESHA, WI 53188-1177
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505180003
DME
WI
05
—
32837900
—
WI
Enumeration date
02/12/2007
Last updated
05/24/2022
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