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General NPI Number Information
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NPI Number | 1851866172
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Entity Type | Organization
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Legal Business Name | GRACE ENDOCRINE SERVICES PLLC
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Dates
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Enumeration Date | 10/13/2018
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 21510 HARRINGTON ST STE 303
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48036-2378
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Country | US
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Telephone | 586-741-5346
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Fax | 586-741-8886
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Provider Business Mailing Address
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Address Line | 21510 HARRINGTON ST STE 303
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48036-2378
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Country | US
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Telephone | 586-741-5346
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Fax | 586-741-8886
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. BERHANE SEYOUM
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Credential | MD
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Telephone | 586-741-5346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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