Saravut S Fung, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

09963 Issued in WV

Practice address

211 S Chestnut St
Clarksburg, WV 26301-2832

Phone

(304) 624-5212

Fax

(304) 623-5812

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saravut S Fung MD Inc

  • Ophthalmology Physician
  • Clarksburg, WV
  • NPI 1871681726
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1093913840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 400",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "681-342-3500",
            "fax_number": "681-342-3507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S CHESTNUT ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012832",
            "telephone_number": "304-624-5212",
            "fax_number": "304-623-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "SARAVUT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "09963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095455000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "406181204",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Freeze
• Lila Mae Friend
• Christine Marie Fubio, MA
• Amber Gail Fuller
• Clifford Warren Fulton I, L.M.T.
• Traci Lyn Furby, RN
• Elizabeth Jean Furner, MS
• Tricia Fury
• Mary Lou Fusco, MS/CCC/SLP
• Paul Gainer, D.D.S.

• Ophthalmology Physician in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Ophthalmology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.