# MIDDLEBURY URGENT CARE &OCCMED, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992766059
- **Authorized official:** DR. STEVENS C MARSHALL D.O. (PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (574) 825-8184

## Contact information

- **Practice address:** 407 N MAIN ST, MIDDLEBURY, IN 46540-9218
- **Practice address phone:** (574) 825-8184
- **Practice address fax:** (574) 825-6176
- **Mailing address:** 407 N MAIN ST, MIDDLEBURY, IN 46540-9218
- **Mailing address phone:** (574) 825-8184
- **Mailing address fax:** (574) 825-6176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 02001282A | IN | Yes |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1396740585 | NATIONAL PROVIDER IDENTIF | IN |