MEDICARE: VOYAGE MEDICAL PRIMARY CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1003595364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOYAGE MEDICAL PRIMARY CARE

Provider Business Mailing Address
First Line	:	1130 W GROVE AVE STE 115
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-4942
Country	:	US
Telephone Number	:	480-306-5000
Fax Number	:	480-452-0300

Provider Business Practice Location Address
First Line	:	1130 W GROVE AVE STE 115
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85210-4942
Country	:	US
Telephone Number	:	480-685-0930
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ALI IMRAN
Credential	:	MD
Telephone Number	:	480-685-0930

Provider Enumeration Date	:	07/14/2023
Last Update Date	:	09/12/2024

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