Imelda S Bulatao, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD00040961 Issued in TN

Practice address

2525 Desales Ave
Pathology Laboratory
Chattanooga, TN 37404

Phone

(423) 495-8703

Fax

(423) 495-6175

NPI assigned

Apr 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1114981602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3637",
            "address_2": "ATTN JUDY H NOWLIN",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-629-7688",
            "fax_number": "423-495-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "address_2": "PATHOLOGY LABORATORY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-495-8703",
            "fax_number": "423-495-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULATAO",
        "first_name": "IMELDA",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MN",
            "license": "35906",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MO",
            "license": "R7H57",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "MD00040961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Buehner
• Carmen Alicia Buffington
• Lauren Marie Buffington
• Judith Buhrman, NP
• Victoria Bui
• Joseph Todd Bullard, ATC
• Rebecca Briane Bullock, OT
• Shirley C Bumpass
• Jacelon L Bunger, M.ED.
• Danielle Lee Bunn

• Anatomic Pathology & Clinical Pathology Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.