Provider Demographics
NPI:1306334792
Name:GLOVER, MATTHEW EARL (BOCP)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:EARL
Last Name:GLOVER
Suffix:
Gender:M
Credentials:BOCP
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Mailing Address - Street 1:220 WESTINGHOUSE BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4260
Mailing Address - Country:US
Mailing Address - Phone:980-585-3571
Mailing Address - Fax:980-585-3572
Practice Address - Street 1:220 WESTINGHOUSE BLVD STE 405
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4260
Practice Address - Country:US
Practice Address - Phone:980-585-3571
Practice Address - Fax:980-585-3572
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist