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Proactive MD Wi Sc — NPI 1932935962, Waukesha, WI | NPI Central

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OrganizationActive

Proactive MD Wi Sc

NPI 1932935962 · Primary Care Clinic/Center · Waukesha, WI

Provider details

NPI number: 1932935962
Entity type: Organization
Primary specialty: Primary Care Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Jody Addair, Clinical Ops Project Coordinator(317) 556-0017

Specialties & taxonomies

Primary Care Clinic/CenterPrimary261QP2300X
Ambulatory Health Care Facilities

Practice location

20611 Watertown Rd Ste C

Waukesha, WI 53186-1871

Phone: (864) 501-0751

Approximate (ZIP-level) locationGet directions

More WI providers

Mailing address

124 Allawood Ct

Simpsonville, SC 29681-6207

Other names (DBA / former)

Doing business as: Proactive MD Family Health Center

Registry dates

Enumerated: 2024-09-09
Last updated: 2024-09-09
Certified: 2024-09-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.