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Organization
KIDMED PLLC
Active
Organization
KIDMED PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY RAE DURHAM PA-C (PRESIDENT)
(910) 340-1521
Entity
Organization
Contact information
Practice address
1165 CEDAR POINT BLVD STE F, CEDAR POINT, NC 28584-1030
(252) 364-4690
(252) 606-4325
Mailing address
228 E IVYBRIDGE DR, HUBERT, NC 28539-5401
(910) 340-1521
(252) 606-4325
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/19/2024
Last updated
11/19/2025
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