Provider Demographics
NPI:1356343008
Name:BAYER, TODD M (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:M
Last Name:BAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4030 SMITH RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1957
Mailing Address - Country:US
Mailing Address - Phone:513-421-3494
Mailing Address - Fax:513-345-2606
Practice Address - Street 1:4030 SMITH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1957
Practice Address - Country:US
Practice Address - Phone:513-421-3494
Practice Address - Fax:513-345-2606
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI33460208600000X
KY418502086S0129X, 174400000X
OH350913292086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2836015Medicaid
WI32219000Medicaid
KY0677816Medicare PIN
OH314239391Medicare PIN
390490005Medicare ID - Type Unspecified
OH2836015Medicaid
WI32219000Medicaid