Organization
SARAVUT S FUNG MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAVUT S FUNG MD (PRESIDENT)
(304) 624-5212
Entity
Organization
Contact information
Practice address
211 SOUTH CHESTNUT ST, CLARKSBURG, WV 26301
(304) 624-5212
(304) 623-5812
Mailing address
211 SOUTH CHESTNUT ST, CLARKSBURG, WV 26301
(304) 624-5212
(304) 623-5812
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
09963
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095455000
—
WV
Enumeration date
10/10/2006
Last updated
10/12/2007
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