Kanu B Dalal, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

4301042934 Issued in MI

Practice address

1221 Pine Grove Ave
Radiology Dept
Port Huron, MI 48060-3511

Phone

(810) 987-5000

Fax

(810) 985-0032

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blue Water Rad Onc, LLC

  • Radiation Oncology Physician
  • Port Huron, MI
  • NPI 1184272817
  NPD
• Prime Healthcare Services-Port Huron LLC

  • Radiation Oncology Physician
  • Port Huron, MI
  • NPI 1902407844
  NPD
• Marwan Shuayto MD PC

  • Neurology Physician
  • Port Huron, MI
  • NPI 1578819850

  Diagnostic Radiology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1215949060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "address_2": "RADIOLOGY DEPT",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000",
            "fax_number": "810-985-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "address_2": "RADIOLOGY DEPT",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-987-5000",
            "fax_number": "810-985-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAL",
        "first_name": "KANU",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "042934",
            "primary": false
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "MI",
            "license": "4301042934",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301042934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1947181",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Daggett
• Cheyann Delaney Dagnall
• Emad Daher, MD
• Laura Dahnke, RDN, CDE
• Geeta Dalal, PT
• Heather Dalessio
• Shivashankar Damodaran, MD
• Melissa Damon
• Daniel J Wilhelm MD PLLC
• Julia Ashley Daniel, LMSW

• Radiation Oncology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Radiation Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.