Provider Demographics
NPI:1780777482
Name:BROWNE, COLLEEN DAWN (DO)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:DAWN
Last Name:BROWNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:COLLEEN
Other - Middle Name:DAWN
Other - Last Name:LANDINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:9343 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48875-9425
Mailing Address - Country:US
Mailing Address - Phone:517-974-3560
Mailing Address - Fax:517-647-6464
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:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICL013079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H04080Medicare UPIN