Healthcare Provider Details

I. General information

NPI: 1407900194
Provider Name (Legal Business Name): COLLEEN ANNE LINEHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COLLEEN ANNE MALEK MD

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N HOOPER ST
CARO MI
48723-1476
US

IV. Provider business mailing address

1011 S VAN DYKE RD STE D
BAD AXE MI
48413-9630
US

V. Phone/Fax

Practice location:
  • Phone: 989-269-1500
  • Fax:
Mailing address:
  • Phone: 989-269-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberCL089052
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number46380
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD29542
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: