Provider Demographics
NPI:1639562580
Name:LEGER-ST-JEAN, BENJAMIN (MD)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:LEGER-ST-JEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9372 DE LILLE
Mailing Address - Street 2:
Mailing Address - City:MONTREAL
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H1Z 2P5
Mailing Address - Country:CA
Mailing Address - Phone:514-507-4440
Mailing Address - Fax:
Practice Address - Street 1:376 W. 10TH AVE.
Practice Address - Street 2:OHIO STATE UNIVERSITY MEDICAL CENTER,
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-6194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program