Organization
CLASSICARE MEDICAL CONSULT PC, INC
Active
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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