Gem State Pediatrics

NPI #1992853386 in Meridian, Idaho

Provider Information

NPI Number: 1992853386
Entity Type: Organization
Organization Name: Gem State Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: Jan 8, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 520 S EAGLE RD
Address 2: SUITE 1209
City: Meridian
State: Idaho
ZIP Code: 83642-6308
Phone: (208) 706-5460

Authorized Official

Name: DR. MARIO BRUS, MD
Title: OWNER
Phone: (208) 706-5460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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