Individual
DAVID PAUL FIVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 W LIBERTY RD STE C5, ANN ARBOR, MI 48103-9746
(734) 222-9630
(734) 222-9631
Mailing address
3200 W LIBERTY RD STE C5, ANN ARBOR, MI 48103-9746
(734) 222-9630
(734) 222-9631
Taxonomy
Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
404817
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4425476
—
MI
Enumeration date
04/13/2006
Last updated
03/25/2026
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