Grace, Mira

Grace, Mira is an sole proprietor health care provider with primary practice located at 44428 Woodward Avenue Suite 102 , Pontiac MI 48341-5009. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is her primary health care specialty. Grace, Mira can be contacted via phone (734) 712-8700.

Contact Information

Primary practice address
44428 Woodward Avenue Suite 102 Pontiac MI 48341-5009
Phone: (734) 712-8700
Fax: (734) 622-5017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 4301507706 Michigan

Profile Details

NPI number 1659667293
LBN Legal business name Grace, Mira
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2011
Last updated Oct 2nd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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