Provider Demographics
NPI:1902804719
Name:BROWNE, MALACHY F (MD)
Entity Type:Individual
Prefix:
First Name:MALACHY
Middle Name:F
Last Name:BROWNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-8127
Mailing Address - Country:US
Mailing Address - Phone:810-966-3727
Mailing Address - Fax:
Practice Address - Street 1:43171 DALCOMA DR
Practice Address - Street 2:STE 5
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6307
Practice Address - Country:US
Practice Address - Phone:586-226-0682
Practice Address - Fax:586-263-4290
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB637622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4442790Medicaid
MI2607401642OtherBCBS
A77662Medicare UPIN
0502788Medicare ID - Type Unspecified