Healthcare Provider Details

I. General information

NPI: 1104616978
Provider Name (Legal Business Name): OLIVIA ZHOU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11508 LE HAVRE DR
POTOMAC MD
20854-3118
US

IV. Provider business mailing address

11508 LE HAVRE DR
POTOMAC MD
20854-3118
US

V. Phone/Fax

Practice location:
  • Phone: 301-580-2105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOP2000595
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: