Provider Demographics
NPI:1568994929
Name:MA, SHURAN
Entity Type:Individual
Prefix:
First Name:SHURAN
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 PARNASSUS AVE, 4TH FLOOR
Mailing Address - Street 2:SUNY AT STONY BROOK DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-476-9035
Mailing Address - Fax:415-353-9163
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:SUNY AT STONY BROOK DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-444-2975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA182593207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology