# MAYDA VASCULAR, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881737724
- **Authorized official:** DR. JARO MAYDA M.D. (OWNER)
- **Authorized official phone:** (765) 453-8504

## Contact information

- **Practice address:** 3611 S REED RD, SUITE 105, KOKOMO, IN 46902-3828
- **Practice address phone:** (765) 453-8504
- **Practice address fax:** (765) 453-8123
- **Mailing address:** PO BOX 415000, NASHVILLE, TN 37241-5000
- **Mailing address phone:** (765) 453-8504
- **Mailing address fax:** (765) 453-8123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 01052526A | IN | Yes |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 07/12/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200272550 | — | IN |
| 01 | — | DC0358 | RAILROAD MEDICARE | — |