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Mira Grace, MD
Addiction Medicine (Family Medicine) Physician in Pontiac, Michigan
NPI 1659667293

Mira Grace is an Addiction Medicine (Family Medicine) Physician based in Ann Arbor, MI and is specialized in Addiction Medicine. Mira Grace practices in Pontiac, MI and has the professional credentials of MD. The NPI Number for Mira Grace is 1659667293 and holds a License No. (Michigan).

The current practice location address for Mira Grace is 44428 Woodward Avenue Suite 102, Pontiac, MI and can be reached out via phone at 734-712-8700 and via fax at 734-622-5017.

Location: 44428 Woodward Avenue Suite 102, Pontiac, MI, 48105
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659667293
Provider Name
Mira Grace
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
44428 Woodward Avenue Suite 102, Pontiac, MI, 48105
Phone Number
734-712-8700
Fax Number
734-622-5017
Provider Enumeration Date
06/22/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
44428 Woodward Avenue Suite 102
City
Pontiac
State
Michigan
Zip
48341-5009
Phone Number
734-712-8700
Fax Number
734-622-5017
person
Provider Business Mailing Address Details
Address
44428 Woodward Avenue Suite 102
City
Pontiac
State
Michigan
Zip
48341-5009
Phone Number
734-712-8700
Fax Number
734-622-5017
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Addiction Medicine
Taxonomy
207QA0401X
License No.
4301507706 (Michigan)
Definition
A family medicine physician who specializes in the diagnosis and treatment of addictions.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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