Healthcare Provider Details

I. General information

NPI: 1851866172
Provider Name (Legal Business Name): GRACE ENDOCRINE SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2018
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21510 HARRINGTON ST STE 303
CLINTON TOWNSHIP MI
48036-2378
US

IV. Provider business mailing address

21510 HARRINGTON ST STE 303
CLINTON TOWNSHIP MI
48036-2378
US

V. Phone/Fax

Practice location:
  • Phone: 586-741-5346
  • Fax: 586-741-8886
Mailing address:
  • Phone: 586-741-5346
  • Fax: 586-741-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BERHANE SEYOUM
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 586-741-5346