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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
2085 N. CALHOUN ROAD, BROOKFIELD, WI 53005-5003
(262) 928-7100
(262) 928-7111
Mailing address
N17 W24100 RIVERWOOD DR, SUITE 250, WAUKESHA, WI 53188-1131
(262) 928-4100
(262) 928-5835

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RG0100X
Gastroenterology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0505180005
DME
WI
05
32819200
WI
Enumeration date
02/12/2007
Last updated
05/24/2022
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