MEDICARE: SOCHEATA STADTHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183700000X	Pharmacy Technician	0230012617	VA

General Provider Information

NPI Number	:	1861319428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOCHEATA STADTHER

Provider Business Mailing Address
First Line	:	4029 FORGE DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5999 BURKE COMMONS RD
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-2880
Country	:	US
Telephone Number	:	703-249-7943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2026
Last Update Date	:	07/02/2026

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Directions to “ SOCHEATA STADTHER ” Practice Location

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