Individual
KANDIS K. RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-2436
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2436
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
36522
WV
208800000X
Urology Physician
Primary
4301062412
MI
208800000X
Urology Physician
95438
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340H264460
BLUE CROSS-BLUE CROSS
—
05
—
424080010
—
MI
01
—
KR062412
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
12/11/2006
Last updated
06/11/2026
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