Healthcare Provider Details

I. General information

NPI: 1891836680
Provider Name (Legal Business Name): PROHEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 DISCOVERY DR
BROOKFIELD WI
53045-2862
US

IV. Provider business mailing address

N17 W24100 RIVERWOOD DR SUITE 250
WAUKESHA WI
53188-1131
US

V. Phone/Fax

Practice location:
  • Phone: 262-928-7100
  • Fax: 262-928-7111
Mailing address:
  • Phone: 262-928-4100
  • Fax: 262-928-5835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER GEISS, MD
Title or Position: PRESIDENT
Credential:
Phone: 262-928-8669