Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Dominique M Butawan-Ali, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1417121013

Dr. Dominique M Butawan-Ali, MD is an Obstetrics/Gynecology in Memphis, Tennessee. Graduated from University of Tennessee, Hsc, College of Medicine in 2012, 14 years ago. Practices with Mid-South Ob-Gyn PLLC, an 8-clinician group and accepts Medicare assignment. Licensed in Arkansas, North Carolina and Tennessee.

Years since qualifying
14
Trained at
University of Tennessee, Hsc, College of Medicine
Licensed in
AR, NC, TN
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6215 Humphreys Blvd Ste 100 Mid South Ob-Gyn Pllc
Memphis, TN 38120
Phone: (901) 747-1200
Fax: (901) 747-1220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 54889 (TN)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence E-8519 (AR)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 201200884 (NC)

Record details

NPI number1417121013
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 15, 2008
Last updated in NPPESOctober 16, 2025
Certification dateOctober 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolUNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Mid-South Ob-Gyn Pllc — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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