Provider Demographics
NPI:1457361172
Name:AYER, NATHAN RUSSELL (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:RUSSELL
Last Name:AYER
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:2500 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:NORTH MEDICAL OFFICE BUILDING
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9004
Mailing Address - Country:US
Mailing Address - Phone:970-203-7050
Mailing Address - Fax:970-203-7055
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE
Practice Address - Street 2:NORTH MEDICAL OFFICE BUILDING
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9004
Practice Address - Country:US
Practice Address - Phone:970-203-7050
Practice Address - Fax:970-203-7055
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-00010678207R00000X
CODR.0054301207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83854240Medicaid
CO378125YLB8Medicare PIN
NY02595742Medicaid
VTI08639Medicare UPIN