1316943467 NPI number — DR. NIGEL BRAYER D.C.

Table of content: DR. NIGEL BRAYER D.C. (NPI 1316943467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316943467 NPI number — DR. NIGEL BRAYER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRAYER
Provider First Name:
NIGEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316943467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11443 STATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH ROYALTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44133-3262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-877-9440
Provider Business Mailing Address Fax Number:
440-877-9446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11443 STATE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH ROYALTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44133-3262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-877-9440
Provider Business Practice Location Address Fax Number:
440-877-9446
Provider Enumeration Date:
06/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  3151 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1385 . This is a "CHIROPRACTIC LIFECARE OF" identifier . This identifiers is of the category "OTHER".
  • Identifier: 640281 . This is a "ACN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3151 . This is a "STATE LICENSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 664821523 . This is a "MEDICAL MUTUAL REFERRAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1810903 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9119098823A12 . This is a "ANTHEM BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0005078 . This is a "CIGNA 3" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2448848 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2783428 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5471676 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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