Provider Demographics
NPI:1891678173
Name:CLOVER MD PA
Entity type:Organization
Organization Name:CLOVER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:PIAZZA
Authorized Official - Last Name:KAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-370-0955
Mailing Address - Street 1:117 WACCAMAW AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1829
Mailing Address - Country:US
Mailing Address - Phone:520-370-0955
Mailing Address - Fax:
Practice Address - Street 1:117 WACCAMAW AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1829
Practice Address - Country:US
Practice Address - Phone:520-370-0955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty