No Urut |
No Angg |
Gelar | Nama |
Tempat,
Tanggal lahir |
Alamat Praktek |
1 | 051 | Dr |
Dr T Linaya Sp.P(K) |
Malang
26-10-17 |
|
2 | 053 | Dr | Tjitra
Sutedja Sp.P |
Malang
05-07-24 |
|
3 | 055 | Prof Dr | Adji
Widjaja Sp.P(K) FCCP |
Surabaya
06-02-37 |
Praktik
Pribadi, Jl. Seruni 28 - Surabaya Klinik Widjaja Asthma Center-Surabaya RS Adi Husada - Surabaya |
4 | 056 | Prof DR Dr | Thomas
VM Kardjito Sp.P (K) |
Nganjuk
16-07-38 |
- |
5 | 057 | Prof. Dr | Sayid
Hood Alsagaff Sp.P(K) |
Padang
14-06-42 |
RS
Dharmo - Surabaya RS Husada Utama - Surabaya Praktik Pribadi Jl. Kapuas 16 Surabaya |
6 | 059 | Dr | Djoko
Iman Santoso Sp.P(K) |
Gambiran
15-01-34 |
RS PT.
KAI DAOP VIII Surabaya RS Surabaya Internasional Lab. Diagnostik Sutama Pramita Surabaya |
7 | 060 | Dr H | Abdul
Mukty Sp.P (K) |
Surabaya
19-11-35 |
RS Islam
I - Surabaya RS Al-Irsyad - Surabaya RS PHC - Surabaya |
8 | 065 | Prof DR Dr | Benyamin
P Margono Sp.P(K) FCCP |
Surabaya
04-05-46 |
RS
Siloam Hospital - Surabaya RSUD Dr Soetomo - Surabaya |
9 | 067 | Dr | Singgih
Sp.P |
Randublatung
02-04-23 |
|
10 | 068 | Dr | Sahim
Rusdiah Sp.P |
Pasuruan
23-05-29 |
|
11 | 069 | Dr H | Slamet
Hariadi Sp.P(K) |
Ponorogo
22-09-46 |
RSUD Dr
Soetomo - Surabaya Praktik Pribadi Jl. Mangundiprojo 22-24 Sidoarjo |
12 | 070 | Prof DR Dr | Muhammad
Amin, Sp.P(K) |
Gresik
10-08-47 |
RS
William Booth-Surabaya RSUD Dr Soetomo-Surabaya RS St. Vincentius A Paulo-Surabaya |
13 | 071 | Dr H | Samsul
Harun Alrasjid, Sp.P(K) |
Probolinggo
07-04-36 |
RS, Jl
Karangmenjangan 98 Surabaya RS, Jl Raya Kenongo 22 Sidoarjo |
14 | 073 | Dr | M Yusuf
Wibisono Sp.P(K) |
Boyolali
02-01-47 |
RSUD Dr
Soetomo Surabaya RS Arofah - Mojokerto |
15 | 074 | Dr | Suratman
T. Karim Sp.P(K) |
Surabaya
16-03- |
Praktik Pribadi Jl. Grambnan Baru 42 Surabaya |
16 | 075 | Dr | Sumarno
Sp.P(K) |
Buyaran
Demak
01-10-39 |
RS
Surabaya Internasional-Surabaya RS Siti Khodijah-Surabaya Klinik Jonggolo - Surabaya |
17 | 078 | Dr | Achmad
Muchidin Razak Sp.P |
Probolinggo
18-08-41 |
Klinik
Medika Yani Group-Surabaya Klnik Jl. AH Nasution No. 6 -Probolinggo Klinik Jl. Panglima Sudirman-Kraksaan |
18 | 079 | Dr | Amin
Aryono Sp.P |
13-06-33
|
Praktik Pribadi Jl. Mangunegoro 7 Surabaya |
19 | 164 | DR Dr | J.F.
Palilingan Sp.P(K) |
Surabaya
06-10-44 |
RSUD Dr
Soetomo - Surabaya RKZ St Vincentius a Paulo - Surabaya |
20 | 168 | Dr | Kemas M
Adil Sp.P(K) |
03-04-45
|
|
21 | 171 | Dr | Indra
Pinarta Sp.P |
Bojonegoro
26-04-45 |
Praktik
Pribadi Jl. Dr Soetomo 55 Madiun RS Santa Clara-Madiun RS Siti Asih-Madiun |
22 | 188 | Dr | Sri
Prihatini Boestan Sp.P(K) |
Yogyakarta
26-05-45 |
- |
23 | 195 | Dr | Kasdi
Soepadmo Sp.P |
Lumajang
31-05-47 |
HVA
Tulungrejo - Pare RS Amelia - Pare Kediri Praktik Pribadi Jl. Kartini - Pelem Pare |
24 | 196 | Dr | Susanti
Sp.P |
Malang
24-04-50 |
|
25 | 211 | Dr | Donny
Irawan Sp.P |
Surabaya
28-11-81 |
RS
Internasional - Surabaya Praktik Pribadi Jl. Kalianyar 50 - Surabaya RS Adi Husada - Surabaya |
26 | 213 | Dr H | Sofyan
Hasan Siregar Sp.P |
Labuhan
Bilik
27-07-47 |
RS Prof.
Dr Setiawan Kertosudirjo-Bangkalan Praktik Pribadi Jl. Zainal Alim 32-Bangkalan |
27 | 215 | Dr | Handojo
Padmosoeparto, MSc, Sp.P |
Mojokerto
20-01-37 |
RS PHC Tanjung Perak - Surabaya |
28 | 217 | Dr | Isnu
Pradjoko Sp.P(K) |
Blitar
22-08-50 |
RSUD Dr
Soetomo - Surabaya Klinik Kimia Farma 23 - Surabaya RS Privata - Surabaya |
29 | 218 | Dr | Soewedo
WS Sp.P |
Lamongan
23-08-50 |
|
30 | 220 | DR Dr | Tahan P
Hutapea Sp.P MARS |
Tarutung
06-09-50 |
Siloam
Hospital - Surabaya RS Katolik St. Vincentius A Paulo-Surabaya RS Darmo - Surabaya |
31 | 222 | Dr | Budi
Haryanto Sp.P |
06-08-49
|
RSUD
PamekasanJl. Mandilaras RS Larasati - Pamekasan Klinik Jl. Purba 20 - Pamekasan |
32 | 225 | Dr | Budi
Lasmono Sp.P |
Surabaya
03-04-55 |
RS
Bhayangkara Polda Jatim - Surabaya Klinik Qurota Rungkut Kidiul - Surabaya |
33 | 226 | Dr | Rusli
Witono Sp.P |
Semarang
08-08-48 |
RSU
Blambangan - Banyuwangi RS Islam Fatimah - Banyuwangi RS Yasmin - Banyuwangi |
34 | 246 | Dr | Harianto
Tanumihardjo Sp.P |
Surabaya
11-09-51 |
Poli Paru RKZ Jl. Ciliwung Surabaya |
35 | 247 | Dr | Daniel
Maranatha Sp.P(K) |
Surabaya
23-06-55 |
RSUD Dr
Soetomo - Surabaya RS Mitra Keluarga - Surabaya Praktik Pribadi Jl. Kupang Jaya No.1D Surabaya |
36 | 249 | Dr | Ediyono
Sp.P |
Magelang
13-02-55 |
Praktik
Pribadi Jl. Kedung Klinter I/26 Surabaya RS Medis Pusura - Surabaya RSAL Dr Ramelan-Surabaya |
37 | 250 | Dr | T. Herry
Santosa Sp.P |
Tuban
27-03-53 |
RS Budi
Mulya - Surabaya RS Dharmo - Surabaya |
38 | 252 | Dr | Yanto
Poernomohadi Sp.P |
Bojonegoro
|
RSAL
Ramelan - Surabaya RS Bakti Rahayu - Surabaya |
39 | 280 | Dr H | Endro
Sukmono Sp.P |
Pekalongan
03-11-54 |
RS Haji
Sukolilo-Surabaya RS Siti Khodijah - Surabaya |
40 | 284 | Dr | Winariani
K, Sp.P(K) |
Sampang
13-07-54 |
RSUD Dr
Soetomo - Surabaya RS Graha Amerta - Surabaya RS Islam Jemur Sari - Surabaya |
41 | 287 | Dr | Edi
Nurtjahjo Sp.P |
Jakarta
10-06-52 |
RS Dr
Soebandi - Jember RS PTPN XII Jember Praktik Pribadi, Sumberan Ambulu-Jember |
42 | 288 | Dr | Nurlaeli
S. Indronoto Sp.P |
Pemalang
16-10-54 |
RSUD
Bangil Pasuruan RS Masyitoh - Bangil Pasuruan RS Muhammadiyah Lamongan |
43 | 290 | Dr H | Soedarsono
Sp.P(K) |
Surabaya
23-11-55 |
RSUD Dr
Soetomo - Surabaya RS Islam Jl. Jemur Sari - Surabaya Apotik Khen Jl. Arjuno 6 - Surabaya |
44 | 302 | Dr | Purwanto
Sp.P |
Madiun
21-03-57 |
RS Paru
- Jember RS Perkebunan - Jember RS Bina Sehat - Jember |
45 | 337 | Dr | Arief
Hermanto Sp.P |
Surabaya
07-09-57 |
RSUD
Mojokerto RS PTP Gatol - Mojokerto Apotik Kimia Farma Jl. Gajah Mada No. 62 Mojokerto |
46 | 339 | DR Dr | Mulyadi
Sp.P |
Aceh
Selatan
19-08-62 |
|
47 | 342 | Dr | Rustam
Effendi Sp.P |
Pontianak
28-06-58 |
RSU
Jombang Jatim Apotik Setia - Jombang Apotik Jombang - Jombang |
48 | 343 | DR Dr H | .A.
Zainullah Sp.P |
Bangkalan
07-10-61 |
RSUD Dr
Soetomo - Surabaya Apotik Teratai Lumajang Apotik Purnama - Surabaya |
49 | 345 | Dr H | Asjhar
Sp.P |
Malang
14-10-62 |
RSUD
Genteng Banyuwangi RS Alhuda - Genteng Banyuwangi |
50 | 346 | Dr | Budi
Sutedja Sp.P |
Surabaya
03-12-63 |
Dr R. Sosodoro Djatikoesoemo - Bojonegoro |
51 | 347 | Dr | Supriyadi
Sp.P |
Sidoarjo
08-08-58 |
RSUD
Moh. Saleh Probolinggo Praktik Pribadi Jl. Tambak Rejo Indah Sidoarjo Praktik Pribadi Jl.Panjaitan No. 55 - Probolinggo |
52 | 350 | Dr | Diah
Roesmawati Sp.P |
Surabaya
30-05-63 |
RS Anisa
- Blitar RS Budi Rahayu Blitar Praktik Pribadi Jl. Pang. Sudirman 71 Blitar |
53 | 351 | Dr | Caecilia
F Lusida, Sp.P |
Surabaya
13-05-60 |
RSU
Gresik Jatim Praktik Pribadi Jl. Bogowonto 53 Surabaya |
54 | 353 | Dr | Krisbiyanto
Sp.P |
Bangil
23-01-61 |
RSUD Dr
Harjono-Ponorogo Klinik Puspa Husada-Ponorogo RS Umum Aisyiyah-Ponorogo |
55 | 356 | Dr | Didik
Purbandiyono Sp.P |
Jombang
29-01-58 |
RS Ngudi
Waluyo-Kab. Blitar RS Syuhada - Blitar Klinik Apotik Ismangil 1 - Blitar |
56 | 395 | Dr | Syahril
Hidayat Sp.P |
Sampang
22-06-59 |
RSUD
Gambiran - Kediri RS Ahmad Dahlan - Kediri Praktik Pribadi Jl. Imam Bonjol 25 Kediri |
57 | 396 | Dr | Bambang
Sadworo Sp.P |
Madiun
02-12-59 |
RSU Dr
Iskak - Tulungagung RSI Orpeha - Tulungagung Klinik Putra Waspada - Tulungagung |
58 | 398 | Dr | Helmia
Hasan Sp.P(K) |
Yogyakarta
15-11-59 |
RSUD Dr
Soetomo - Surabaya RS. Wijaya - Surabaya |
59 | 401 | Dr | Nur
Indah Sawitri Sp.P |
Surabaya
27-01-65 |
RS Haji
Sukolilo - Surabaya RS Islam A Yani - Surabaya |
60 | 402 | Dr | Mei Budi
Prasetyo Sp.P |
Magetan
17-05-61 |
RSUD
Nganjuk RS Islam Jl. Imam Bonjol - Nganjuk |
61 | 403 | Dr | Muzaijadah
Retno Arimbi Sp.P |
Surabaya
23-10-63 |
RS Islam
Surabaya RS Muhammadiyah Gresik Praktik Pribadi Jl. Pacar kembang 151 Surabaya |
62 | 404 | Dr | R. Moh.
Iqbal Adisukarno Sp.P |
Yogyakarta
31-05-61 |
RSUD
Gambiran - Kediri RS Bhayangkara - Kediri Klinik Apotik Kimia Farma-Kediri |
63 | 405 | Dr | Hanto
Wihardjo Sp.P |
Pati
29-03-63 |
RSJ
Menur - Surabaya RS Adi Husada Kapasari - Surabaya Praktik Pribadi Jl. Bendul Merisi 48 Surabaya |
64 | 407 | Dr | Hermawan
CH Sp.P |
Jombang
12-04-60 |
RSU Pare RS HVA Perkebunan - Pare RS Amelia - Pare |
65 | 408 | Dr | Dwiraras
Radityawan Sp.P |
Madiun
30-03-61 |
RSUD
Sidoarjo RS Siti Hajar - Sidoarjo Praktik Pribadi Jl. Raya Gelam 6 Sidoarjo |
66 | 410 | Dr | Atok
Irawan Sp.P |
Sidoarjo
01-05-66 |
RSUD
Sidoarjo RS Delta Surya Sidoarjo Widjaja Asthma Center - Surabaya |
67 | 412 | Dr | Oktiningsih
Sp.P |
Kediri
30-04-65 |
RS Mitra
Keluarga - Surabaya Praktik Pribadi Jl. Raya Kutorejo Prima Indah |
68 | 413 | Dr | Bambang
Subarno Sp.P |
Madiun
30-04-65 |
RSU Madiun |
69 | 414 | Dr | Sigit
Aprianto , Sp.P |
Malang
24-04-59 |
RS Mardi
Waluyo - Blitar Praktik Pribadi Jl. Veteran 18 - Blitar RS Budi Rahayu - Blitar |
70 | 423 | Dr | Kusdiantoro
, Sp.P |
Madiun
12-07-61 |
BP4 Karang Tembok |
71 | 424 | Dr | Jan Arif
Kadarman, Sp.P |
Bandung
27-04-64 |
RSAL
Ilyas - Tarakan Praktik Pribadi Jl. Diponegoro No. 12 Tarakan |
72 | 426 | Dr | Laksmi
Wulandari Sp.P |
Surabaya
16-05-68 |
RSUD Dr
Sotomo - Surabaya RS Graha Amerta - Surabaya RS Husada Utama - Surabaya |
73 | 507 | Dr | Agus
Hidayat Sp.P |
Ponorogo
17-08-64 |
RSU Sayidiman Magetan |
74 | 513 | Dr | Farida
Anggraini Soetedjo , Sp.P |
Surabaya
01-05-68 |
RS
Wijaya Kusuma - Surabaya RS Adi Husada Jl. Undaan Wetan - Surabaya RS Adi Husada Jl. Kapasari- Surabaya |
75 | 522 | Dr | Joko
Minoyo, Sp.P |
Surabaya
29-11-66 |
|
76 | 523 | Dr | Wiwik
Kurnia Ilahi, Sp.P |
Kediri
18-09-67 |
RS
Gredia - Gresik RS Rahmi Dewi - Gresik |
77 | 425 | Dr | Ig. H.
Handoko T Sp.P |
Malang
29-07-61 |
RSAL Dr
Ramelan - Surabaya RS Surabaya Internasional - Surabaya |
78 | 490 | Dr | Afan
Fathur Achmad, Sp.P |
Sidoarjo
28-12-76 |
|
79 | 492 | Dr | Mulyati
Amir, Sp.P |
Makassar
21-04-68 |
|
80 | 506 | Dr | Susaniwati
Sp.P |
Surabaya
10-12-69 |
RSUD Dr M Soewandi - Surabaya |
81 | 510 | Dr | Santoso
Sp.P |
Kediri
16-05-65 |
RS
William Booth - Surabaya Klinik Medis Usura Rungkut - Surabaya |
82 | 511 | Dr | Sajariah
Sp.P |
Malang
25-12-64 |
RSI
Aisyah - Malang RS Wasa Husada - Malang |