DAFTAR NAMA DOKTER UMUM / DOKTER GIGI / DOKTER SPESIALIS

No Nama SMF SMF

ilmu NO SIP
Kebidanan
SMF ilmu
1 dr. ANASTASIA TIYAS RETNANTIANA, Sp. OG dan 445/0620/SIP.DS.1/423.104/2017
Kebidanan
2 Jakarta,
dr. MOH.29 Mei 1961
FAUZI, Sp.OG Kandungan
dan 21 Desember 2017
503/004/SIP.DS.01/423.207/2014
NIP. 19610529
Malang, 13 198812
Agustus 2 001
1963
3 dr. MOCHAMAD HARIES FRIYADI Sp.OG Kandungan 15 Oktober 2014
NIP. 19630813
Surabaya, 27 199011
Februari 1 001
1975
4 dr. DARMOJO KANDINATA, Sp.PD
NIP. 19750227 200312 1 007
5 Jakarta, 30 Maret
dr. ZAINUDIN 1960Sp.PD
ZUHRI
NIP. 19600330 199010
19671 Sp.
002
6 Pasuruan,
dr. FARIED18 April
IRAWANTO, PD
NIP. 19670418
Kediri, 199803 1 010
22 AMBARWATI,
Mei 1973 SMF Ilmu 503/007/SIP.DS.01/423.207/2014
dr. NINIK Sp.A
7 NIP. 19730522
Jombang, 200212 11975
29 Desember 005 Penyakit Anak 14 November 2014
8 dr.
NIP.SHINTA RESTUNINGWIYANI
19751229 200311 2 001 Sp. A. M.biomed SMF Ilmu 445/0616/SIP.DS.1/423.104/2017
9 Banyuwangi,
dr. PHERENICE23 Agustus
CHARISTI, 1981
Sp. A Penyakit Anak 20 Desember 2017
NIP. 19810823 200904 503/398/SIP.DU.01/423.207/2016
10 Lumajang, 29 Juli
dr. ADI WIDIANTO 1983 2 001 SMF Dokter 27 Desember 2016
NIP. 19830729
Surabaya, 200904 1975
04 Februari 2 001 Umum
dr. STIAEDES SMF Dokter 445/0138/SIP.DU.1/423.104/2017
NIP. 19750204November
Pekanbaru,05 200604 1 011
1970 Umum 01 MARET 2017
NIP. 19701105 201001 2 001
11
12 dr. BAZATULO HIA, Sp.B
13 Sifatalago
dr. DOSHI Gomo,
GURITNO,20 Oktober
Sp.OT 1964
NIP. 19641020 198901 1 1966
004
14 Surabaya, 23 Nopember
dr. IDA BAGUS EKA ABIDHARMA, Sp.An 503/060/SIP.DS.01/423.207/2015
NIP. 19661123
Denpasar, 19 199607
April 19641 001
15 dr. RIFTA YUSTIARDI SUDJOKO, SpB SMF
SMF Bedah
Bedah 31 Maret 2015
445/0224/SI.DU.2/423.104/2017
NIP. 19640419 199011 1 002
16 dr. PRASETYO Tulang 06 APRIL 2017
NIP. 19800330 200604
19601Sp.P
010
17 Bogor, 17INDAHYANTI,
dr. FITRI Februari
NIP. 19600217Juli198803 1 003
18 Pasuruan
dr. CATUR7ELVI 1977
PURNAMAWATI, Sp. P SMF Dokter 445/0185/SIP.DU.1/423.104/2017
NIP. 19770707 2006041977
2 034
19 Pasuruan 12 Pebruari
dr. WITO ASTOERA Umum 18 Maret 2017
445/0159/SIP.DS.2/423.104/2017
NIP. 19770212 200312
1960 2 005
20 Malang,
dr. WAHYU15 Juli
KUSBIANTO, SpS SMF
SMF Syaraf
Dokter 06 Maret 2017
503/389/SIP.DU.02/423.207/2016
NIP. 19600715
Kediri,20 Mei 198802 1 002
1967
21 dr. SUDARMANTO Umum
SMF Kulit dan 27 Desember 2016
503/321/SIP.DS.01/423.207/2016
NIP. 19670520 201001 1 001
22 Surabaya,
dr. RAPHAEL 12 Maret 1963
GRATIANO, Sp.KK Kelamin 27 SEPTEMBER 2016
NIP. 19630312
Malang,21 1989121966
Desember 1 004
23 dr. ERNY DISTRIANDARI, Sp. M SMF Dokter 503/253/SIP.DU.02/423.207/2015
NIP. 19661221Desember
Mojokerto,06 199603 11962
001
24 dr. NIEKEN DEVIYANTI PANDAN RARAS Umum 10 November 2015
NIP. 19621206 198901 21980
001
25 Sidoarjo,
dr. YUNING29 KURNIATI.
September Sp. THT SMF Dokter 445/0136/SIP.DU.1/423.104/2017
NIP. 19800929Juni201101
1968 2 007
26 Sidoarjo,26
dr. M. BURHAN Umum 28 februari 2017
NIP. 19680620 199803
19702 003 Sp.Pros
27 Pasuruan,
drg. ARINI 14
EKO April
MYANGSIH, 445/0838/SIP.DRGS.1/423.104/2018
NIP. 19700414 200604 1 011
28 Malang,01 Juni 1961Sp.Ort
drg. SUHARTONO. SMF Prostodon05 Juli 2018
445/0312/SIP.DRGS.1/423.104/2017
NIP. 19610601 198703 2 004
29 Banyuwangi,01
drg. BAGUS TEGUH Mei 1967
UTOMO SMF Bedah Mul09 Agustus 2017
503/309/SIP.DRG.01/423.207/2016
NIP. 19670510 199101
200604 11 002
30 NIP. 19791221
drg. MEI YUNIARTI 012 SMF Dokter Gi 27 September 2016
Surabaya,01 Juni 1978
31 drg. SENDA WIDYA TRIHANDAYANI
NIP. 19780601Juli200904 2 001
32 Pasuruan,18
drg. SETIYAWAN1981
NIP. 1981071817200904 2 0021979
33 Banyuwangi,
dr. EDY HERLAMBANG,SeptemberSp. And 503/125/SIP.DS.02/423.207/2016
NIP. 19790917 Oktober
Mojoagung,01 201001 1967
1 019
34 dr. MOH. ZAKKY KURNIAWAN Sp.JP SMF Ilmu Penya
24 MEI 2016
NIP. 19671001
Ngawi, 30 April 199509
1976 1 001
dr. RETNO ANGGRAENI SMF Dokter 503/393/SIP.DU.01/423.207/2016
35 Surabaya, 12 Mei 1967 1 012
NIP. 19760430 200604 Umum 27 DESEMBER 2016
445/0350/SIP.DU.I/423.104/2017
36 NIP. 19670512
dr. SIS HARTINI200604 2 014
SANTOSO SMF Dokter 06 September 2017
Umum
37 Pamekasan, 19 Maret
dr. LULU AMETA 1961
SUSILOWATI, Sp.Rad
NIP. 19610319
Nganjuk,26 198903
Januari 2 005
1960
38 dr. VITRI BRILYANTINA APRININGSIH, Sp.Rad
NIP. 19600126 198803
1978 2MAITIMU,
004
39 Ternate,08 Maret
dr. MARJORIE RENATA Sp.Pk
NIP. 19780308Nopember
Surabaya,13 200312 21959
006
NIP. 19591113 198709 2 001
40 dr. DEVVI RIASARI, Sp.Pk
Cilacap,
dr. Moh. 08 Juni
Ferry 1975
Nur Abadi
NIP. 19750608 200604 2 021 SMF Dokter 445/0818/SIP.DU.2/423.104/2018
Umum 19 JULI 2018
dr Yunita Findi Aksari SMF Dokter 445/0291/SIP.DU.1/423.104/2017
Umum 05 juli 2017
dr Siti Maria Ulfah SMF Dokter 445/0168/SIP.DU.1/423.104/2017
Umum 08 Maret 2017
dr. Ratna Suryati Halim SMF Dokter 503/372/SIP.DU.01/423.207/2016
Umum 27 Desember 2016
dr Hamzah, Sp.OT SMF Bedah 445/0793/SIP.DS.1/423.104/2018
Tulang 30 April 2018
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