No
Urut |
No
Angg |
Gelar |
Nama
|
Tempat,
Tanggal lahir |
Agama |
Pendidikan |
Alamat
Rumah |
Alamat
Praktek |
Keluarga |
Telp
& HP |
| 1 |
128 |
Dr |
R. A. Handojo Sp.P
|
Surabaya
21-07-30 |
Kristen |
| Umum
|
:
UNAIR , 1960 |
| Spesialis |
: BP4, 1994 Malang |
|
Simpang
Ijen 3 Malang 65112 |
Praktik
Pribadi Jl. Simpang Ijen 3 Malang |
Ny. Catherine Handojo
(i)
Dr Anggraeni Inggrid Handojo
Dra. Imbarwati Imelda Handojo
Ir. Amelia Handojo |
Telp
0341-551 741
HP 0812-3381170 |
| 2 |
131 |
Dr
|
D.
Liunanda Sp.P
|
Banjarmasin
20-07-31 |
Budha |
| Umum
|
:
UNAIR , 1961 |
| Spesialis |
:BP4, 1977 Malang |
|
Balaikota
31 Pasuruan 67125 |
Praktik
Pribadi Jl. Balaikota 31 Pasuruan |
Ny.
Irawati (i)
Joice Yeniarti Liunanda
Dr David R. Liunanda, SpP
Evan Liunanda |
Telp
0343 - 426 250 |
| 3 |
132 |
Dr
|
Roeslan
Djailani Sp.P
|
Bukittinggi
12-12-32 |
Islam |
| Umum
|
:
UGM , 1964 |
| Spesialis |
:BP4, 1971 |
|
Rinjani
10 Malang 65112 |
- |
Dra.
Hj. Betty Machmud (i)
Dr Moh. Alfa Ferry Santoso, Sp.BTKV
Drs. Moh. Edwin D Ramafitra
Drs. Moh. Raymond Leowira |
Telp
0341-570 816, 551 800 |
| 4 |
134 |
Dr
|
J
Wibisono Sp.P
|
Purwokerto
23-06-31 |
Katolik |
| Umum
|
:
UI, 1961 |
| Spesialis |
:BP4, 1975 Malang |
|
Anjasmoro
9 Malang 65112 |
Praktik
Pribadi Jl. Anjasmoro 9 Malang /
Jl. Kauman 30 Malang
RS Panti Waluyo Malang |
Ny.
Liza Wibisono (i) |
Oki
Agus Wibisono |
| 5 |
136 |
Dr
|
S
Suwandi Sp.P
|
Malang
15-11-30 |
Islam |
| Umum
|
:
UNAIR , 1959 |
| Spesialis |
:BP4, 1997 |
|
Biliton
19 - Madiun Telp 0351 - 462 139 |
Praktik
Pribadi Jl. Bilitton 19 Madiun |
Ny.
Djasa Krishtina (i)
Ir. Ismail Setiawan
Slamet Santoso
Iman Subagio |
Telp
0351 - 462 139 |
| 6 |
166 |
Dr
|
Miko
Tongku Sp.P
|
Tamako
15-11-30 |
Kristen |
| Umum
|
:
UNAIR , 1976 |
| Spesialis |
:UNAIR , 1989 |
|
Mayjend.
Sungkono 42 Kediri 64121 |
Praktik
Pribadi Jl. Mayjen Sungkono 42 Kediri
RS Bhayangkara-Kediri
RS Muhammadiyah-Kediri |
Drg.
Magdalena T. Prihadi (i)
Kartika Tongku
Denny Tongku
Christopher Tongku |
Telp
0354 - 683 212
HP 0812-3531982
|
| 7 |
189 |
Dr
|
Sandi
Agung Sp.P
|
Surabaya
03-03-44 |
Kristen |
| Umum
|
:
UNIBRAW, 1976 |
| Spesialis |
:UNAIR , 1988 |
|
Tambora 42 Malang 65146
|
RS
Panti Nirmala - Malang
RS Panti Waluyo-Malang
Apotik Nusakambangan-Malang |
Ny.
Mia Setiawati (i)
Anne Andia |
Telp
0341 - 563 219
HP 0816-556929 |
| 8 |
194 |
Dr
|
S
Boedi Rahardja Sp.P
|
Malang
20-12-47 |
Kristen |
| Umum
|
:
UNIBRAW , 1947 |
| Spesialis |
:UNAIR , 1985 |
|
Letjend
Panjaitan 4 Jember 68122 |
Praktik
Pribadi Jl. Letjen Panjaitan 4 Jember
Klinik PTPN X Jember
Rumkit Tk III Jember |
Ny.
Jane Eveline Caecilia (i)
Ny. Jane Eveline Caecilia
Roy Marcelus Rahardja
Louis Jacobus Rahardja |
Telp
0331 - 337 924 |
| 9 |
216 |
Dr
|
Koentjahja
Sp.P
|
Malang
30-09-49 |
Katolilk |
| Umum
|
:
UNIBRAW, 1978 |
| Spesialis |
: UNAIR , 1990 |
|
Wilis
Indah A-6 Malang 65115 |
Klinik
Apotik Kimia Farma 53-Malang
RS Panti Waluya Jl. Nusakambangan 56 Malang |
Dr
Henny CK, Sp.P (i)
N. Mayasari Soedarko |
Telp
0341 - 568 711
HP 0812-3300525 |
| 10 |
243 |
Dr
|
Nunuk
Sri Muktiati Sp.P (K)
|
Blora
05-12-51 |
Katolik |
| Umum
|
:
UNIBRAW , 1980 |
| Spesialis |
: UNAIR , 1992 |
|
Sulfat
82 Malang 65122 |
RSUD
Saiful Anwar - Malang
RS Paru Alveoli - Malang
Kliniki Jl. Patimura 23 Malang |
Dr
Sudiro, Sp.Rad(K) (i)
Irana Eraningtyas
L. Ima Monica |
Telp
0341 - 484 452
HP 0811 - 367 314 |
| 11 |
289 |
Dr
|
Teguh
Rahayu Sartono Sp.P (K)
|
Tulungagung
06-09-54 |
Islam |
| Umum
|
:
UNAIR , 1981 |
| Spesialis |
: UNAIR , 1994 |
|
Burangrang
7A Rt. 05 Rw. 06 Gading Kasri Klojen Malang 65115 |
RSUD
Dr Saiful Anwar - Malang
RS Islam Unisma - Malang
RS Panti Nirmala - Malang |
Dr
Enny Liestyawati, Sp.Rad (i)
Tony Prima Julianto
Hamka Aditya Erlangga
Dimas Muhammad Isa |
Telp
0341 - 572 700
HP 0812 - 323 9709 |
| 12 |
224 |
Dr
|
Jan
Hendrokusumo Sp.P
|
Malang
23-01-48 |
Protestan |
| Umum
|
:
UNIBRAW , 1979 |
| Spesialis |
: UNAIR , 1992 |
|
Perumahan
Permata Hijau D-69 Tlogomas Malang 65144 |
RS
Paru Batu - Malang
Apotik Lawang - Malang
Apotek Semeru-Malang |
Ny.
Indra Kumalasari |
Telp
0341 - 554 304
HP 0812-3366862 |
| 13 |
233 |
Dr
|
Rustina
Rachmad M.Kes, Sp.P
|
Sumenep
09-06-42 |
Katolik |
| Umum
|
:
UNIBRAW , 1977 |
| Spesialis |
: UNIBRAW, 2001 |
|
Lokon
20 Malang 65142 |
Klinik
Jl. Hasyim Ashari 16 - Malang
RS Panti Waluya - Malang
RS Panti Nirmala - Malang |
Tn.
Djoko Pramono (s)
Veronika Yulia Rustina |
Telp
0341 - 576 818
HP 0852-17886888 |
| 14 |
234 |
Dr
|
Henny
Chandrawati, M.Kes, Sp.P
|
Banjarmasin
22-05-49 |
Katolik |
| Umum
|
:
UNIBRAW , 1979 |
| Spesialis |
: UNIBRAW, 2006 |
|
Wilis
Indah A-6 Malang 65115 |
RSUD
Dr Saiful Anwar Malang
RS Panti Nirmala Malang
RS Panti Waluya Malang |
Dr
Koentjahja Sp.P (s)
N. Mayasari Soedarko |
Telp
0341 - 364110
HP 0812-3300561 |
| 15 |
300 |
Dr
|
Moch
Zainun Sp.P
|
Surabaya
26-03-55 |
Islam |
| Umum
|
:
UNIBRAW , 1984 |
| Spesialis |
: UNAIR , 1996 |
|
Jend
Sudirman 13 A Pogar - Bangil 67153 |
RSUD
Kab. Bangil - Pasuruan
RS Islam Masitoh Bangil - Pasuruan |
Ny.
Susi Andayani (i)
Rahendra Hafandi, SH
Ferdianto Prabowo, SH
Dr Vita Ovaria
Septiardhi Husodo |
Telp
0343 - 7744567
HP 0816-15859345 |
| 16 |
430 |
Dr
|
Paulus
Wibowo Sp.P
|
Malang
19-03-69 |
Kristen |
| Umum
|
:
UNIBRAW , 1994 |
| Spesialis |
: UNIBRAW, 2003 |
|
Punten
6 Malang 65141 |
RS
Panti Waluya-Malang
Apotik Dieng-Malang
Praktik Pribadi Jl. Punten 6 Malang |
Dr
Juliani Dewi (i)
Jeanne Gabrielle Wibowo
Alexandra Victooria Wibowo |
Telp
0341 - 495 337
HP 0816 - 555 734 |
| 17 |
432 |
Dr
|
Joko
Susilo Sp.P
|
Tulungagung
18-03-64 |
Islam |
| Umum
|
:
UNIBRAW , 1989 |
| Spesialis |
: UNIBRAW, 2003 |
|
Desa
Karangsuko Trenggalek 66314 |
RSUD
Trenggalek
RS Budi Asih - Trenggalek
Praktik Pribadi Desa Karangsuko Trenggalek |
Dr
Niken Suharsi (i)
Nikko C.M.F
Naufal C.J.S
Najmi C.J.S |
Telp
0355 - 793 586
HP 0812 - 357 3132 |
| 18 |
543 |
Dr
|
Yani
Jane R Sugiri Sp.P
|
Jakarta
17-12-63 |
Katolik |
| Umum
|
:
UNIBRAW , 1989 |
| Spesialis |
: UNIBRAW, 2005 |
|
Pandan
19 Malang 65151 |
RS
Dr Saiful Anwar - Malang
RS Panti Waluya - Malang
Apotik Sari Medika - Malang |
Dr
Jaya Pranata Suwana (s)
Monica Audrey Jaya Suwana
Maria Karina Jaya Suwana |
Telp
0341 - 580236
HP 0811 - 366 847 |
| 19 |
544 |
Dr
|
Setiaji,
Sp.P
|
Malang
09-06-61 |
Islam |
| Umum
|
:
UNIBRAW , 1992 |
| Spesialis |
: UNIBRAW, 2006 |
|
Laksari
2 Perum Sejahtera I No. 7 Tuban 62315 |
RSUD
Tuban
RS Medika Mulya - Tuban
Praktik Pribadi Jl. Laksari - Tuban |
Dra.
Susmiati (i)
Ahmitasari Nurisa Susatyo
Ahmadin Yusuf Rizal Susatyo
Ahmad Danisa Nur Afifah Susatyo |
Telp
0356-323976
HP 0812 - 3316678 |
| 20 |
546
|
Dr
|
Susanthy
Djajalaksana, Sp.P
|
Bandung
07-05-62 |
Islam |
| Umum
|
:
UNPAD , 1998 |
| Spesialis |
: UNIBRAW, 2005 |
|
D
Limboto A5 C33 Sawojajar Permai - Malang 65139 |
RSUD
Saiful Anwar - Malang
RS Lavalette - Malang |
Dr
Iwan Donosepoetro, Sp.B (i)
Intan Waseputri Donoseputro
Bimo Donoseputro |
Telp
0341 - 715 161
HP 0811 - 367 731 |
| 21 |
547 |
Dr
|
Wara
Pertiwi, Sp.P
|
Malang
10-02-62 |
Islam |
| Umum
|
:
UNIBRAW , 1989 |
| Spesialis |
: UNIBRAW, 2007 |
|
Candisari
III / 4 Malang 65142 |
- |
Tn.
Nachrowie (s)
Rizki Fani AU
Priska Annastasia A.K
Nikita AP
Adinda P.P.P |
Telp
0341 - 473 145
HP 0818 - 538 786 |
| 22 |
604 |
Dr
|
N.
Putu Parsama Putra, Sp.P
|
Bali
12-08-66 |
Hindu |
| Umum
|
:
UNAIR , 1991 |
| Spesialis |
: UNIBRAW, 2006 |
|
Titian
Asri VI / CC 23 Malang |
RSUD
Dr Saiful Anwar Malang
RS Panti Nirmala - Malang |
Dra.
EC. Nyoman Sri Mahayuni (i)
Ngakan Gede Arya Mahayuni
Ngakan Made Yoga Widi Nugraha |
Telp
0341 - 415490
HP 0815-55682900 |
| 23 |
605 |
Dr
|
Nini
Deritana , Sp.P
|
Kediri
27-11-58 |
Protestan |
| Umum
|
:
UNIBRAW , 1994 |
| Spesialis |
: UNIBRAW, 2007 |
|
Griya
Wage Asri A12 Taman - Sidoarjo |
- |
Tn.
Sabar Manullang (s)
Brigita Sanina Manullang |
Telp
0341 - 8540435
HP 0812-3350572 |
| 24 |
606 |
Dr
|
Tahri
Iskandar , Sp.P
|
Aceh
17-09-62 |
Islam |
| Umum
|
:
UNIBRAW , 1991 |
| Spesialis |
: UNIBRAW, 2007 |
|
Mercoyo
I / 20 Gondanglegi Malang 65174 |
- |
Ny.
Tutut Eny Sri Kustatin (i)
Affan Ramadhan
Farhan Baliyan |
Telp
0341-879652
HP 0812-3353151
|
| 25 |
609 |
Dr
|
Triwahyu
Astuti, Mkes, Sp.P
|
Jember
22-10-66 |
Islam |
| Umum
|
:
UNIBRAW , 1980 |
| Spesialis |
: UNIBRAW, 2008 |
|
Danau
Sentani Utara H2A31 Sawojajar Permai Malang |
RSUD
Saiful Anwar - Malang
RS Islam Aisyiah - Malang
Praktik Pribadi Jl. Danau Sentani Utara Malang |
Ir.
Triagus Djoko Kuntjoro, MT (s)
Andina Gustria Caesary
Andita Gustria Caesary
Emeralda Gustria Sesari |
Telp
0341 - 712655
HP 08123297361 |
| 26 |
610 |
Dr
|
Paul
A. Dwiyanu, Sp.P
|
Surabaya
|
Islam |
| Umum
|
:
UNIBRAW , 1998 |
| Spesialis |
: UNIBRAW, 2008 |
|
Simpang
Sulfat Utara VII / 14 Malang |
- |
Dr
Christiana Wahyuningrum (i)
Patricia Gita AD
Wilma Kartikaning P |
HP
0813-34622996 |
