Healthcare Provider Details

I. General information

NPI: 1376206771
Provider Name (Legal Business Name): VOYAGE MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 09/06/2023
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 S RURAL RD STE 101
TEMPE AZ
85282-2455
US

IV. Provider business mailing address

2402 S RURAL RD STE 101
TEMPE AZ
85282-2455
US

V. Phone/Fax

Practice location:
  • Phone: 480-685-0930
  • Fax:
Mailing address:
  • Phone: 480-685-0930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ALI IMRAN
Title or Position: MD
Credential: MD
Phone: 480-685-0930