Provider Demographics
NPI:1669360954
Name:BAYER, OLIVIA NOELLE (PA-C)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:NOELLE
Last Name:BAYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-1854
Mailing Address - Country:US
Mailing Address - Phone:248-268-2566
Mailing Address - Fax:
Practice Address - Street 1:348 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1854
Practice Address - Country:US
Practice Address - Phone:248-268-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant