Provider Demographics
NPI:1255575924
Name:MA, SHUAIKE (MD)
Entity type:Individual
Prefix:
First Name:SHUAIKE
Middle Name:
Last Name:MA
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 1:2661 WINGATE WAY NW
Mailing Address - Street 2:APT. 4
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-8942
Mailing Address - Country:US
Mailing Address - Phone:330-479-1464
Mailing Address - Fax:
Practice Address - Street 1:250 S 21ST ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3851
Practice Address - Country:US
Practice Address - Phone:610-250-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-26
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT194229207R00000X
CT53100207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine