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Individual

KERIC LICKERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2500
(314) 268-7133
(314) 577-8516
Mailing address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2500
(314) 268-7133

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2023026688
MO

Other

Enumeration date
03/26/2020
Last updated
07/12/2023
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