Provider Demographics
NPI:1518288828
Name:CLOVER, CHARLES ROUSE (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ROUSE
Last Name:CLOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:502 W KING ST STE LL20
Mailing Address - Street 2:
Mailing Address - City:KINGS MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28086-3362
Mailing Address - Country:US
Mailing Address - Phone:704-862-4700
Mailing Address - Fax:704-862-4749
Practice Address - Street 1:502 W KING ST # LL20
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3362
Practice Address - Country:US
Practice Address - Phone:704-862-4700
Practice Address - Fax:704-862-4749
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2012-00261207L00000X, 208VP0014X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine