Provider Demographics
NPI:1891777678
Name:JOYNER, NEDRA HELENE (MD)
Entity Type:Individual
Prefix:DR
First Name:NEDRA
Middle Name:HELENE
Last Name:JOYNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 MITCHELLVILLE RD STE A414
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3142
Mailing Address - Country:US
Mailing Address - Phone:301-860-0985
Mailing Address - Fax:301-860-0978
Practice Address - Street 1:4000 MITCHELLVILLE RD STE A414
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3142
Practice Address - Country:US
Practice Address - Phone:301-860-0985
Practice Address - Fax:301-860-0978
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD89726207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA711135387AMedicaid
IL036-069631-4Medicaid
GA202I046783Medicare PIN
ILE71082Medicare UPIN
IL036-069631-4Medicaid