Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Impact Physician Group, Wisconsin LLC

Organization Internal Medicine Physician · NPI 1174291025

Impact Physician Group, Wisconsin LLC is an Internal Medicine Physician in Milwaukee, Wisconsin. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3200 S 103rd St
Milwaukee, WI 53227-4104
Phone: (469) 640-6500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1174291025
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paul Miller — Ceo · (678) 967-5599
NPI enumeratedSeptember 3, 2021
Last updated in NPPESDecember 19, 2022
Certification dateDecember 19, 2022
Mailing address21 Eastbrook Bnd Ste 218, Peachtree City, GA 30269-1546

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