MS. DOMINIQUE M BUTAWAN-ALI


Address: 6215 Humphreys Blvd., Ste 100, Memphis, TN 38120
Phone: 9017471200

MS. DOMINIQUE M BUTAWAN-ALI (NPI# 1417121013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417121013
Entity Type Individual
Full Name MS. DOMINIQUE M BUTAWAN-ALI
Other Name DR. DOMINIQUE M BUTAWAN
Credential MD
Practice Address 6215 Humphreys Blvd., Ste 100
Memphis
TN 38120
Mailing Address 6215 Humphreys Blvd Ste 100
Wcc Mpllc Dba Mid South Ob-gyn Pplc
Memphis
TN 38120
Practice Telephone 9017471200
Practice Fax Number 9017471220
Mailing Telephone 9017471200
Mailing Fax Number 9017471220
Enumeration Date 2008-04-15
Last Update Date 2017-01-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207V00000X Obstetrics & Gynecology 54889 TN Allopathic & Osteopathic Physicians
N 207V00000X Obstetrics & Gynecology E-8519 AR Allopathic & Osteopathic Physicians
N 207V00000X Obstetrics & Gynecology 201200884 NC Allopathic & Osteopathic Physicians

Office Location

Street Address 6215 HUMPHREYS BLVD., STE 100
City MEMPHIS
State TN
Zip Code 38120

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093285637 Cobblestone Midwifery Midwife 5617 Ashley Square South, Memphis, TN 38120 2018-11-27
1649768870 River City Neuropsychology, Pllc Psychologist 1661 International Dr., Suite 400, Memphis, TN 38120 2018-04-24
1841676152 Jody Lavaun Clements Dentist 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 2015-08-10
1578957122 Christina Lumpkin Nurse Practitioner 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 2015-03-21
1316352099 Daniel Poor Emergency Medicine Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 2014-06-21
1245643246 Kysha Saleem Nurse Practitioner 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 2014-06-06
1376962613 John Christopher Swearingen Dentist 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 2014-04-15
1275884645 Rebecca Leigh Goedecke Nurse Practitioner 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 2012-09-26
1730475179 Sarah Elizabeth Hammond Surgery Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 2011-06-23
1922302785 Daniel L Hester Nurse Anesthetist, Certified Registered 1755 Kirby Parkway Suite 330, Memphis, TN 38120 2011-01-07
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Taxonomy Information

Taxonomy Code 207V00000X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology

Taxonomy Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043860448 901 Health, Pllc Obstetrics & Gynecology 3068 Covington Pike Ste 3, Memphis, TN 38128-5001 2019-09-17
1669860557 Midsouth Healthcare Management Obstetrics & Gynecology 3249 W Sarazens Cir, Memphis, TN 38125-0807 2014-12-31
1104269745 Abigail Y. Talbot Obstetrics & Gynecology 6215 Humphreys Blvd Ste 500, Memphis, TN 38120-2384 2013-04-13
1972863165 Robin Morehead Taylor Obstetrics & Gynecology 6215 Humphreys Blvd Ste 100, Memphis, TN 38120-2382 2012-05-21
1972782670 Ob Gyn Centers of Memphis,mpllc Obstetrics & Gynecology 1264 Wesley Dr Ste 402, Memphis, TN 38116-6447 2007-10-30
1699963249 Stephen Eguabor Ehiremen Obstetrics & Gynecology 2900 Kirby Rd Ste 11, Memphis, TN 38119 2007-10-09
1902013238 Carlos Zavala Obstetrics & Gynecology 1850 Poplar Crest Cv, Suite 105, Memphis, TN 38119-4877 2007-05-17
1578775359 Laura B Haskins Obstetrics & Gynecology 6005 Park Ave Ste 430b, Memphis, TN 38119-5211 2007-05-04
1598892325 Memphis Midsouth Obgyn Alliance P.C. Obstetrics & Gynecology 6215 Humprehys Blvd, Suite 400, Memphis, TN 38120 2007-02-28
1689709388 Memphis Women's Healthcare, Inc Obstetrics & Gynecology 6060 Primacy Pkwy Ste 251, Memphis, TN 38119-5751 2007-02-22
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City MEMPHIS
Zip Code 38120

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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