Individual
AVERY THOMAS PELLNAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4618
(207) 662-6254
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4618
(207) 662-6254
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD30340
ME
208M00000X
Hospitalist Physician
Primary
MD30340
ME
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
05/07/2026
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