Provider Demographics
NPI:1114312634
Name:BAYER, RENEE L (MD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:L
Last Name:BAYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:LESPERANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:612 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4828
Mailing Address - Country:US
Mailing Address - Phone:734-904-1498
Mailing Address - Fax:
Practice Address - Street 1:37595 7 MILE RD STE 230
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1003
Practice Address - Country:US
Practice Address - Phone:734-743-4540
Practice Address - Fax:734-743-4541
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI43011168432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program