David Fivenson, M.D.Dermatology, PLLC

Primary specialty

Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X

License

DF404817 Issued in MI

Legal business name

DAVID FIVENSON, M.D.DERMATOLOGY, PLLC

Practice address

3200 W Liberty Rd Ste C5
Ann Arbor, MI 48103-9746

Phone

(734) 222-9630

NPI assigned

May 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Fivenson, MDNPI 1235193525

Title

President

Phone

(734) 222-9630

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9738/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Paul Fivenson, MD

  • Clinical & Laboratory Dermatological Immunology Physician
  • Ann Arbor, MI
  • NPI 1235193525
  Medicare reassignment Authorized official
• Loren Camano Shkolnik

  • Family Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1548746779
  NPD (past)
• Camila Antia, MD

  • Dermatology Physician
  • Bellaire, TX
  • NPI 1457746562
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1205037454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W LIBERTY RD STE C5",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039746",
            "telephone_number": "734-222-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W LIBERTY RD STE C5",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039746",
            "telephone_number": "734-222-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID FIVENSON, M.D.DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "FIVENSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-222-9630",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "MI",
            "license": "DF404817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DF404817",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robertson D Davenport, MD
• Ryan Davenport
• Davia Steinberg Ogg, PH.D., LLC
• David a. Schlitt, Psy.D., LP, LLC
• David Beltzman MD Inc.
• David J Fulkerson LMSW PLLC
• David K. Vallance, M.D., P.C.
• David Klimek PHD PC
• Christelle Marie David, OTR
• Sara Marie David, RN

• Dermatology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.