OrganizationActive
Integrated Dermatology of Idaho LLC
NPI 1508345091 · Dermatology Physician · Boise, ID
Provider details
- NPI number
- 1508345091
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Queen, Owner(561) 314-2000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
388 E Parkcenter Blvd
Boise, ID 83706-3942
Phone: (208) 424-9101
Fax: (208) 424-5072
Approximate (ZIP-level) locationGet directions
Mailing address
4700 Exchange Ct Ste 110
Boca Raton, FL 33431-4450
Other names (DBA / former)
- Doing business as
- Gem State Dermatology
Registry dates
- Enumerated
- 2018-08-07
- Last updated
- 2018-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.