Organization
CLASSICARE MEDICAL CONSULT PC, INC
Active
Other names
Classicare Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. XIANGDONG YOU MD (PRESIDENT)
(770) 489-5000
Entity
Organization
Contact information
Practice address
4904 TIMBER RIDGE DR STE 303, DOUGLASVILLE, GA 30135-1831
(770) 489-5000
(770) 489-0305
Mailing address
4904 TIMBER RIDGE DR STE 303, DOUGLASVILLE, GA 30135-1831
(770) 489-5000
(770) 489-0305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
050465
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000934007E
—
GA
01
—
0403355
UNITED HEALTH CARE
—
01
—
2089568
FIRST HEALTHCARE
—
01
—
21232609899
BEECH STREET
—
01
—
258835797
TRICARE
—
01
—
320129
WELLCARE OF GEORGIA
GA
01
—
3462913
CIGNA
—
01
—
52895315
BCBS
—
01
—
6104
KAISER
—
01
—
7676325
AETNA
—
01
—
782253003
GREAT-WEST
—
01
—
P00242355
MEDICARE RAILROAD
—
Enumeration date
03/12/2007
Last updated
09/17/2019
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