Provider Demographics
NPI:1730140229
Name:DURDEN, ABIGAIL W (DO)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:W
Last Name:DURDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:RODGERS
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:NEWTON GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28366-0227
Mailing Address - Country:US
Mailing Address - Phone:910-567-6194
Mailing Address - Fax:910-567-5342
Practice Address - Street 1:3331 EASY ST
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-7988
Practice Address - Country:US
Practice Address - Phone:910-567-6194
Practice Address - Fax:910-567-5342
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891359CMedicaid
H95495Medicare UPIN
NC891359CMedicaid