SIRISHA R. NANDALUR (NPI# 1508070152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508070152 |
Entity Type | Individual |
Full Name | SIRISHA R. NANDALUR |
Credential | MD |
Practice Address |
44201 Dequindre Rd Troy MI 48085-1117 |
Mailing Address |
26901 Beaumont Blvd Ste 3d Southfield MI 48033-3849 |
Practice Telephone | 2489645000 |
Practice Fax Number | 2489646158 |
Enumeration Date | 2007-05-10 |
Last Update Date | 2020-10-20 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
4301083705 | MI | Allopathic & Osteopathic Physicians |
Street Address |
44201 DEQUINDRE RD |
City | TROY |
State | MI |
Zip Code | 48085-1117 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801892468 | Mary Margaret Guerra | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2005-06-28 |
1578163523 | Laura Marie Metz | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-29 |
1538767983 | Virginia Clare Fielhauer | Physician Assistant | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-16 |
1437756095 | Amanda Michelle Hirsch | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-07 |
1467059113 | Scott Matthew Grumeretz | Physical Therapist | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-06 |
1285231944 | Brianne Patton | Physical Therapist | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-10-06 |
1679180483 | John L Freds | Registered Nurse | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-25 |
1720694300 | Justine Marie Doss | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-19 |
1649885872 | Sara Dawn Thueme | Nurse Practitioner | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-09-14 |
1316561772 | Jodi Marini | Registered Nurse | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2020-06-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790327252 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd #120, Suite 120, Troy, MI 48085 | 2019-10-16 |
1538712948 | Long Lake Rx | Pharmacy | 2888 East Long Lake Rd, Suite 120, Troy, MI 48085 | 2019-07-24 |
1669035093 | William Beaumont Hospital | Pharmacy | Beaumont Hospital Troy, 44201 Dequindre, Room 11a0310, Troy, MI 48085 | 2019-04-22 |
1487126926 | Long Lake Rx | Pharmacy | 2888 E Long Lake Rd Suite 120, Troy, MI 48085 | 2018-12-21 |
1295226579 | Jeffrey Paul Biehl | Nurse Anesthetist, Certified Registered | 44249 Dequindre Rd., Troy, MI 48085 | 2018-05-23 |
1619478666 | Trisha Misiewicz | Physical Therapist | 42201 Dequindre Rd, Troy, MI 48085 | 2018-02-26 |
1760900393 | Sensory Rehabilitation LLC | Physical Therapist | 4413, Reilly Ct, Troy, MI 48085 | 2017-09-04 |
1841710837 | James L Chang | Dentist | 1883 E Wattles, Troy, MI 48085 | 2017-06-21 |
1033567953 | Brittany N David | Physician Assistant | 2041 E Square Lake Rd Suite 300, Troy, MI 48085 | 2016-06-01 |
1053784199 | Brianna Lynn Manica | Nurse Practitioner | 44201 Dequindre Rd., Ste. 400 Troy Beaumont Hospital, Troy, MI 48085 | 2015-11-12 |
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Taxonomy Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902809445 | Ronald Karl Setzkorn | Radiology | 3130 N Dixie Hwy, Troy, OH 45373-1337 | 2005-05-30 |
1164758025 | Zachary A Seymour | Radiology | 44201 Dequindre Rd, William Beaumont Hospital, Troy, MI 48085-1117 | 2009-10-28 |
1437312402 | Benjamin Scott Laser | Radiology | 2215 Burdett Ave, Troy, NY 12180-2466 | 2008-07-09 |
1710147756 | Peter Paximadis | Radiology | 1560 E Maple Rd, Suite 400 - Credentialing Dept, Troy, MI 48083-1138 | 2008-06-12 |
1952582496 | We Care 4u Co | Radiology | 3130 N Dixie Hwy, Troy, OH 45373-1337 | 2007-11-26 |
1922068923 | Gregory Gustafson | Radiology | 44201 Dequindre Rd, Troy, MI 48085-1117 | 2006-03-24 |
1740240894 | Jannifer S Stromberg | Radiology | 44201 Dequindre Rd, William Beaumont Hospital, Troy, MI 48085-1117 | 2006-03-24 |
1336131598 | Troy Radiation Oncology Pllc | Radiology | 2215 Burdett Ave, Samaritan Cancer Care Center, Troy, NY 12180-2466 | 2005-08-15 |
1104826056 | Sarada M Reddy | Radiology | 2215 Burdett Ave, Samaritan Hosptial Cancer Care Center, Troy, NY 12180-2466 | 2005-07-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
1811444235 | Gwendolyn Henderson Parker | Radiology | 48165 Liberty Dr, Shelby Twp, MI 48315-4061 | 2016-09-01 |
1376097733 | Munson Medical Center | Radiology | 217 S Madison Avenue, Traverse City, MI 49684-2320 | 2016-08-15 |
1972985737 | Andrew Thompson | Radiology | 44378 Dequindre Rd Fl 1, Sterling Heights, MI 48314-1003 | 2015-06-29 |
1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
1932533692 | Compass Healthcare, Plc | Radiology | 2175 Coolidge Rd, East Lansing, MI 48823-1379 | 2013-08-29 |
1083903256 | Omar Hesham Gayar | Radiology | 4100 Beecher Rd Ste A, Flint, MI 48532-3661 | 2011-03-28 |
1881906519 | Sanath Kumar | Radiology | 18101 Oakwood Blvd Ste 411, Oakwood Hospital, Dearborn, MI 48124-4089 | 2010-07-10 |
1376772574 | Matthew W Packard | Radiology | 145 Michigan St Ne - Suite 2200, Lemmen-holton Cancer Pavilion (radiation/oncology), Grand Rapids, MI 49503 | 2009-07-08 |
1053575118 | North Macomb Mrt Center LLC | Radiology | 17900 23 Mile Road, Macomb Twp, MI 48042 | 2008-07-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.