Individual
DR. DOMINIQUE M BUTAWAN-ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6215 HUMPHREYS BLVD STE 100, MID SOUTH OB-GYN PLLC, MEMPHIS, TN 38120
(901) 747-1200
(901) 747-1220
Mailing address
6215 HUMPHREYS BLVD STE 100, MEMPHIS, TN 38120-2382
(901) 747-1200
(901) 747-1220
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
201200884
NC
207V00000X
Obstetrics & Gynecology Physician
Primary
54889
TN
207V00000X
Obstetrics & Gynecology Physician
E-8519
AR
Other
Enumeration date
04/15/2008
Last updated
10/16/2025
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