Provider Demographics
NPI:1952058471
Name:COLLEEN D. BROWNE DO PC
Entity Type:Organization
Organization Name:COLLEEN D. BROWNE DO PC
Other - Org Name:COLLEEN D. LANDINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-789-9355
Mailing Address - Street 1:25620 GIBRALTAR RD
Mailing Address - Street 2:
Mailing Address - City:FLAT ROCK
Mailing Address - State:MI
Mailing Address - Zip Code:48134-1243
Mailing Address - Country:US
Mailing Address - Phone:734-789-9355
Mailing Address - Fax:734-789-1520
Practice Address - Street 1:25620 GIBRALTAR RD
Practice Address - Street 2:
Practice Address - City:FLAT ROCK
Practice Address - State:MI
Practice Address - Zip Code:48134-1243
Practice Address - Country:US
Practice Address - Phone:734-789-9355
Practice Address - Fax:734-789-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1780777482Medicaid