Provider Demographics
NPI:1811303449
Name:GRADWOHL, STEPHEN CHARLES II (MD, MSCI, MSACI)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CHARLES
Last Name:GRADWOHL
Suffix:II
Gender:M
Credentials:MD, MSCI, MSACI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:
Practice Address - Street 1:3601 THE VANDERBILT CLINIC
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-7106
Practice Address - Country:US
Practice Address - Phone:615-936-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN607642083C0008X, 208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine