# KANDIS K. RIVERS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114087988
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 36522 | WV | — |
| 208800000X | Urology Physician | 4301062412 | MI | Yes |
| 208800000X | Urology Physician | 95438 | SC | — |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 06/11/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 340H264460 | BLUE CROSS-BLUE CROSS | — |
| 05 | — | 424080010 | — | MI |
| 01 | — | KR062412 | CHAMPUS-CHAMPUS | — |