NPIMap

Organization Active NPI

Saravut S Fung MD Inc

  • Ophthalmology Physician
  • Clarksburg, WV
National Provider Identifier
1871681726
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
09963 Issued in WV
Legal business name
SARAVUT S FUNG MD INC
Practice address
211 South Chestnut St
Clarksburg, WV 26301
Phone
(304) 624-5212
Fax
(304) 623-5812
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Dr. Saravut S Fung, MDNPI 1093913840
Title
President
Phone
(304) 624-5212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 09963 WV Primary

Addresses

Primary practice location

211 South Chestnut St
Clarksburg, WV 26301

Mailing address

211 South Chestnut St
Clarksburg, WV 26301
Phone (304) 624-5212

Other identifiers 1

IdentifierTypeStateIssuer
0095455000MedicaidWV

National Provider Directory

National Provider Directory

Locations

211 S Chestnut St
Clarksburg, WV 26301
Phone (304) 624-5212

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1871681726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SOUTH CHESTNUT ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-624-5212",
            "fax_number": "304-623-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SOUTH CHESTNUT ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-624-5212",
            "fax_number": "304-623-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARAVUT S FUNG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "FUNG",
        "authorized_official_first_name": "SARAVUT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-624-5212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "09963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095455000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; 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.