Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gem State Dermatology, PA

Organization Dermatology Physician · NPI 1912040270

Gem State Dermatology, PA is a Dermatology Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

388 E Parkcenter Blvd
Boise, ID 83706
Phone: (208) 424-9101
Fax: (208) 424-5072
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence M7247 (ID)
Medical Specialty Clinic/Center Taxonomy 261QM2500X · Licence M7247 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA377 (ID)

Record details

NPI number1912040270
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Morgan — Practice Manager · (208) 424-9101
NPI enumeratedFebruary 15, 2007
Last updated in NPPESDecember 2, 2014
Mailing addressPo Box 1603, Boise, ID 83702-1603

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