Organization
MAYDA VASCULAR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARO MAYDA M.D. (OWNER)
(765) 453-8504
Entity
Organization
Contact information
Practice address
3611 S REED RD, SUITE 105, KOKOMO, IN 46902-3828
(765) 453-8504
(765) 453-8123
Mailing address
PO BOX 415000, NASHVILLE, TN 37241-5000
(765) 453-8504
(765) 453-8123
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
01052526A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200272550
—
IN
01
—
DC0358
RAILROAD MEDICARE
—
Enumeration date
02/14/2007
Last updated
07/12/2010
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