Individual
JOHN PELLERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
833 SAINT VINCENTS DR STE 403, BIRMINGHAM, AL 35205-1614
(205) 939-0447
Mailing address
833 SAINT VINCENTS DR STE 403, BIRMINGHAM, AL 35205-1614
(205) 939-0447
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.1772
AL
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA.1772
PA
AL
Enumeration date
03/22/2021
Last updated
02/24/2023
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