Healthcare Provider Details

I. General information

NPI: 1568439784
Provider Name (Legal Business Name): DAVID I MALITZ MD., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 W FLAMINGO RD STE 1
LAS VEGAS NV
89103-3788
US

IV. Provider business mailing address

1001 WALNUT ST
EVANSVILLE IN
47713-1963
US

V. Phone/Fax

Practice location:
  • Phone: 702-368-2010
  • Fax:
Mailing address:
  • Phone: 812-421-2020
  • Fax: 812-422-1189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID I MALITZ
Title or Position: OWNER
Credential:
Phone: 812-421-2020