NPI 1003482019

Grace Pediatrics PC

Organisation Primary Care Clinic/Center Pontiac, MI

Practice location

Address: 44200 Woodward Ave STE 103, Pontiac, MI 48341-5046
Phone: (248) 253-9600
Fax: (248) 253-0980

Authorised official

Name: Roy Pullukat
Title: Owner
Phone: (248) 884-3879

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X

Other Clinic/Center providers in Michigan →

Registry record

NPI: 1003482019
Entity type: Organization
NPI issued: 1 Jun 2021
Record last updated: 1 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.