Provider Demographics
NPI:1790479509
Name:BENARD-SEGUIN, ETIENNE JEAN-CHARLES ANDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ETIENNE
Middle Name:JEAN-CHARLES ANDRE
Last Name:BENARD-SEGUIN
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 1:1914 260 ST SW UNIT A
Mailing Address - Street 2:UNIT A
Mailing Address - City:CALGARY
Mailing Address - State:ALBERTA
Mailing Address - Zip Code:T3E2B7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1365B CLIFTON ROAD NE
Practice Address - Street 2:DEPARTMENT OF OPHTHALMOLOGY (NEURO- OPHTHALMOLOGY)
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:613-898-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program