Keric Lickerman, MD
Emergency Medicine in Saint Louis, MO. Individual provider (NPI-1).
NPI number1730716705
StatusActive
Last updated in NPPESJul 12, 2023
Details
- NPI
- 1730716705
- Entity type
- Individual (NPI-1)
- Name
- Keric Lickerman
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 26, 2020
- Certification date
- Jul 12, 2023
- Last updated
- Jul 12, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - EMERGENCY MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 2023026688 | MO | Yes |
Practice location
3635 Vista AveSaint Louis, MO 63110-2500
Phone 314-268-7133 · Fax 314-577-8516
Mailing address
3635 Vista AveSaint Louis, MO 63110-2500
Phone 314-268-7133
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