Provider Demographics
NPI:1316943467
Name:BRAYER, NIGEL (DC)
Entity type:Individual
Prefix:DR
First Name:NIGEL
Middle Name:
Last Name:BRAYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11443 STATE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3262
Mailing Address - Country:US
Mailing Address - Phone:440-877-9440
Mailing Address - Fax:440-877-9446
Practice Address - Street 1:11443 STATE RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3262
Practice Address - Country:US
Practice Address - Phone:440-877-9440
Practice Address - Fax:440-877-9446
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1385OtherCHIROPRACTIC LIFECARE OF
640281OtherACN
OH3151OtherSTATE LICENSE
664821523OtherMEDICAL MUTUAL REFERRAL
1810903OtherUNITED HEALTHCARE
9119098823A12OtherANTHEM BC/BS
0005078OtherCIGNA 3
OH2448848Medicaid
2783428OtherAETNA
5471676OtherAETNA
664821523OtherMEDICAL MUTUAL REFERRAL
0005078OtherCIGNA 3
U69229Medicare UPIN
BR9353311Medicare ID - Type Unspecified