Individual
MYRTICE E MACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(313) 343-1000
Mailing address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(313) 343-1000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301044291
MI
208VP0014X
Interventional Pain Medicine Physician
Primary
4301044291
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505010782
BCBS
MI
Enumeration date
07/23/2006
Last updated
09/11/2025
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