Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Gem State Pediatrics

Organization Pediatrics Physician · NPI 1992853386

Gem State Pediatrics provides Pediatrics Physician services in Meridian, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007

Practice location Address checks out

520 S Eagle Rd Ste 1209
Meridian, ID 83642-6308
Phone: (208) 706-5460
Fax: (208) 706-5465
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence M5562 (ID)

Record details

NPI number1992853386
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mario Brus — Owner · (208) 706-5460
NPI enumeratedJanuary 8, 2007
Last updated in NPPESAugust 22, 2020
Mailing address520 S Eagle Rd, Suite 1209, Meridian, ID 83642-6308

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