Provider Demographics
NPI:1194777391
Name:BAYER, WILLIAM H (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:BAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5357
Mailing Address - Country:US
Mailing Address - Phone:585-576-5306
Mailing Address - Fax:
Practice Address - Street 1:1086 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5357
Practice Address - Country:US
Practice Address - Phone:585-576-5306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2023-08-21
Deactivation Date:2023-01-31
Deactivation Code:
Reactivation Date:2023-08-09
Provider Licenses
StateLicense IDTaxonomies
NY143714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0103826260Medicaid
NYE15896Medicare UPIN
NY0103826260Medicaid