Provider Demographics
NPI:1164053021
Name:BAYER, MICHELLE LOREE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LOREE
Last Name:BAYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4816 N ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1415
Mailing Address - Country:US
Mailing Address - Phone:248-276-5063
Mailing Address - Fax:
Practice Address - Street 1:4816 N ADAMS RD
Practice Address - Street 2:
Practice Address - City:OAKLAND TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48306-1415
Practice Address - Country:US
Practice Address - Phone:248-276-5063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist