IndividualActive
Mira Grace, MD
NPI 1659667293 · Addiction Medicine (Preventive Medicine) Physician · Pontiac, MI
Provider details
- NPI number
- 1659667293
- Entity type
- Individual
- Primary specialty
- Addiction Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 4301507706 (MI)
Practice location
44428 Woodward Avenue Suite 102
Pontiac, MI 48341-5009
Phone: (734) 712-8700
Fax: (734) 622-5017
Mailing address
44428 Woodward Ave Ste 102
Pontiac, MI 48341-5009
Registry dates
- Enumerated
- 2011-06-22
- Last updated
- 2026-04-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.