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
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
10/28/2025
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