Healthcare Provider Details

I. General information

NPI: 1548488836
Provider Name (Legal Business Name): GRETCHEN AILEEN COADY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD 5TH FLOOR
GREENVILLE SC
29605-4210
US

IV. Provider business mailing address

1736 OLD YORK RD
YORK SC
29745-9458
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-4411
  • Fax:
Mailing address:
  • Phone: 803-620-2929
  • Fax: 844-749-4370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number229801
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37427
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37427
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number229801
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number37427
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: