Basic Information
| Provider Information | |||||||||
| NPI: | 1356343008 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAYER | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4030 SMITH RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452091957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134213494 | ||||||||
| FaxNumber: | 5133452606 | ||||||||
| Practice Location | |||||||||
| Address1: | 4030 SMITH RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452091957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134213494 | ||||||||
| FaxNumber: | 5133452606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2005 | ||||||||
| LastUpdateDate: | 12/10/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 33460 | WI | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0129X | 41850 | KY | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | 35091329 | OH | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 208600000X | 35091329 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 174400000X | 41850 | KY | N | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 2836015 | 05 | OH | MEDICAID | 32219000 | 05 | WI | MEDICAID |