Pengurus Daerah

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NoDaerah/WilayahNama Ketua dan Sekretaris UmumAlamat, Tlp. Fax. EmailKontak PersonContact Person Tim Verifikasi KTA /STR
1 Pengda Nanggroe Aceh Darusalam Asnawi Abdullah , SKM, MHSM, MSc.HPPF, DLSHTM, Ph.D Jln. Kampus Unmuh No. 49 Lumbata Banda Aceh Kode Pos 4234
Fax. 0651-34091, Telp. 0651-33773
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Bapak Asnawi Abdullah
Hp. 0852 7505 8091

Asnawi Abdullah, SKM, MHSM, MSc.HPPF, DLSHTM, Ph.D
Hp. 0852 7505 8091
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Farrah Fahdhiehie, SKM, MPH
Wardiati, SKM, M.Kes.
Hp. 0852 6057 5605

2 Pengda Sumatera Utara

Dr. Indra Shalahuddin, M.Kes., MM.

Oslida Martony, SKM, M.Kes.

Dr. Kintoko
FKM Univ. Sumatera Utara
Jln Universitas No. 21 Kampus USU Padang Bulan Medan 20155
Telp. 061-8213221, Fax.061-8213221
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Indra Shalahuddin
Hp. 0811 655 662

Oslida M.
Hp. 0812 6524 704
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Dr. Kintoko
Hp. 0813 7617 2230

Dr. Kintoko
Hp. 0813 7617 2230
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Oslida M.
Hp. 0812 6524 704
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3 Pengda Sumatera Barat

Nizwardhi Azkha, SKM, MPPM, MPd, MSi

Evino Sugiarta,SKM

Jln. Perintis Kemerdekaan No. 65 A Padang
Telp. 0751-39796-25642
Fax. 0751-33437
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Nizwardi Azkhar
Hp. 0812 675 2709
(jln Handayani III/109 Perumdam III Siteba Padang)

Nizwardhi Azkha, SKM, MPPM, MPd, MSi
Hp. 0812 675 2709
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4 Pengda Jambi

Bayrizal, SKM, M.Kes.

Dr. Sukmal Fahri, S.Pd., M.Kes.

Kampus Analis Kesehatan
Jalan H.Agus Salim No. 15 Kota Baru Jambi
Tlp. 0741-41331
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Bayrizal, M.Kes
Hp. 085368167464

H. Subarki, SKM, M.Kes.

Ummi
Hp. 081314385775
5 Pengda Riau

Dr. H. Zainal Abidin, MPH

Nopriadi, SKM, M.Kes

Jalan Mustofa sari No. 5 Tangkerang Selatan Pekanbaru No. Tlp. 0761-33615 fax. 0761-863646
Email : This email address is being protected from spambots. You need JavaScript enabled to view it. This email address is being protected from spambots. You need JavaScript enabled to view it.

Zainal Abidin
Hp. 0812 75866 099/0811 759 199

Nopriadi
Hp. 0812 7707 6757/0853 6591 5691
Fax. 0751-32838

Dr. Zainal Abidin,MPH.
HP. 0812 75 866 099
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H.Ahmad Hanafi, SKM, M.Kes
Hp. 0812 7608 6626
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Nopriadi, SKM, M.Kes
Hp. 0853 65915 691
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Agus Alamsyah. SKM, M.Kes
HP. 0852 1128 4826
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Jasrida Yunita,SKM
Hp. 081371919 944
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Dwi Sapta A.SKM, M.Kes
Hp. 0813 7816 3808
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Betty Nia Rulen, SKM,M.KL
Hp. 0813 6380 3003
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Puspito Rahardjo, SKM
Hp. 0853 65055 958
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6 Pengda Kepulauan Riau

Rustam SKM, Msi. (Ketua)

Tatang Hidayat, SKM, DP&E

a/n Rustam Dinkes Prov. Kepri Jalan Achmad Yani No. 62 Tanjung pinang.
Tlp. Fax. 0771-7331052
Tlp. Fax. 0771-7330151/52
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Rustam
Hp. 0811 779 015
Tatang Hidayat,SKM, DP&E
Hp. 0812 7009 6777

Andi Kurniawan
Hp. 0813 64694 9995
Email: -

7 Pengda Sumsel

Dr. H. Amar Muntaha, SKM, M.Kes.

Erma Agustina, ST, M.Kes.

-

Dr. H. Amar Muntaha.
Hp. 0812 7100 934
Fax.0711-321707 - 420972,
Tlp. 811124

Erma Agustina, ST., M.Kes
Hp. 0813 6806 5660

  • Amar Muntaha, SKM, M.Kes

Hp. 0852 5728 5555
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  • Erma Agustina, ST., M.Kes

Hp. 0813 6806 5660
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

  • Dian Eka A., SKM, M.Kes

Hp. 0813 6720 3713
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8 Pengda Bangka Belitung

Hermain, SKM, MKM.

Sunar Nugroho Adiatmoko, SKM, M.Si

Komplek Perkantoran dan permukiman Terpadu Air Itam Pangkal Pinang Tlp. 0717-439034 Fax. 439085 This email address is being protected from spambots. You need JavaScript enabled to view it.
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Hermain, SKM, MKM.
Hp. 0819 7779 0587
Tlp/Fax 0717-439034

Syarifufin
Hp. 0852 1402 4464
Tlp/fax0717-439034

  • Syarifufin

Hp. 0852 1402 4464
Email: -

  • Ghita Fazrianti

Hp. 0812 7117 1080
Email: -

9 Pengda Bengkulu Drs.Amin Kurnia
Yusrizal M, SKM, M.Kes

STIKES Bhakti Husada Bengkulu. Jalan Kini Balo No. 8 Kel. Kebun Tebeng Kec. Ratu Agung Bengkulu
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Drs. Amin Kurnia, SKM, MM.
Hp. 0852 6735 5387
Tlp. 0736-26306
Fax. 0736-22655 Yusrizal
Hp. 0813 6794 3631

  • Fiya Diniati,SKM, M.Kes

Hp. 0852 680 64242
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

  • A. Tarmizi Daud, SKM, M.Kes.

Hp. 0812 8601 2999
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  • Deltari Novianti, S.Psi, MM.

Hp. 08583 9018 442
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10 Pengda Lampung

Abi Kusno Djamaluddin, SKM, M.Kes

Noviansyah,SKM, MKes, AAK

Dinkes Provinsi Lampung
Jl. Dr. Susilo No. 44-46 Pahoman Bandar Lampung 35213
Telp.0721-267456
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Abi Kusno Djamaluddin HP. (0811795693)
kantor : 0721-704550

Noviansyah, SKM, MKes, AAK
(Dinkes Prov. Lampung)
Tlp. 0721-264091, Fax.257516

Noviansyah, SKM, MKes, AAK
Hp. 0812 793 0932
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11 Pengda Banten Maman Sutisna, SKM, M.Kes.

STIKES FALETEHAN Serang Jalan Raya Cilegon Km 6 Pelamun Kramatwatu, Serang
Telp. 0254-232729, Fax. 230054
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Maman Sutisna, SKM
Hp. 0812 9459 040

Muklasin
Hp. 0857 1458 9703

Muklasin
Hp. 0877 7439 1870
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12 Pengda DKI Jakarta

Dr. Hj. Dien Emawati, SKM

Edwin Nasli, SKM

Ka Dinkes Prov. DKI Jakarta Jl. Kesehatan No. 10 Jakarta Pusat, Blok B lt.1
Tlp. 021-3813217
Fax. 34834872/73
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dr.Dien E.
Hp. 0815 8642 0058

Edwin Nasli
Hp. 0818 0664 2608

Refni Dumesti
Hp. 0812 8686 7099
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Amir Abyan, SKM
Hp. 0897 865 7439
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13 Pengda Jawa Barat

dr. Hj. Ahyani Raksanagara, M.Kes.                   

Ejeb Ruhyat, SKM., M.Kes

Pascasarjana IKM UNPAD Jalan Prof. Eijekman No. 38 Bandung

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Ahyani Raksanagar
Hp. 0812-8998-0911

Ejeb Ruhyat
Hp. 0813-2179-9973; 0878-2320-0424
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Sofyan Effendi
Hp. 0815-6004-267; 0878-8969-8913; 0812-2145-8382
Email:
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Deni K. Sunjaya
Hp. 0813-2835-6775

Sofyan Effendi
Hp. 0815 6004 267
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14 Pengda Jateng DR. Dr. Sutopo Patriajati, MM, M.Kes

Ari Wuryanto, SKM, M.Kes

FKM UNDIP, Tembalang, Semarang Jawa Tengah
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Dr. Sutopo
Hp. 08122844066

Ari Wuryanto
Hp. 08122843519

Ari Wuryanto, SKM, Mkes
Hp. 0812 284 3519
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15

Pengda DI Yogyakarta

Prof dr Laksono Trisnantoro, MSc., Ph.D

drg. Daryanto Chadorie, BSc.,Mkes

PMPK-FK UGM d.a. Gd. IKM Baru, Sayap Utara lt 2 Jalan farmako sekip utara yogyakarta 55281
Telp/Fax. 0274-549423-25
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Prof. Laksono
Hp. 0811 253 295

Jati
Hp. 08122 769 708

Ariyanto Nugroho
Hp. 0819 3178 3263
Email: -

16 Pengda Jawa Timur Dr. Djazuly Chalidyanto, SKM, MARS.

Lutfi Agusalim, SKM, MSc.

FKM UNAIR Jalan Muliorejo Kampus C Unair - Surabaya
Telp. 031-5920948
Fax. 031-5924618/597113
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Dr. Djazuly Chalidyanto, SKM, MARS.
Hp. 08123265097

Lutfi Agusalim, SKM, MSc.
Hp. 08123141371

Lutfi Agusalim, SKM, MSc.
Hp. 0812 3141 371
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Sigit Ari Saputro, SKM, M.Kes
Hp. 0856 4037 0265
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Didiek Rachmadi, SKM, MPPM
Hp. 0812 1755 0439
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17 Pengda Bali dr. Partha Muliawan, MSc.

Dr. A.A A S. Sawitri

Prodi IKM Univ. Udayana
(PS IKM UNUD)
Jalan P.B. Sudirman Sanglah Denpasar
Telp. / Fax. 0361-7448773 / 781504 atau Alamat Rumah Pak Partha Jalan Kerta Husada V / 50 Denpasar 80224
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Dr. Partha Muliawan
Hp. 0812 460 9151

Dwipayanti
Hp. 08133 823 4802

Sang Gede Purnama, SKM, MSc.
Hp. 0877 3917 6777
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18 Pengda Nusa Tenggara Barat Mohammad Abdullah, SKM, MQIH

Zulhana, SKM, MM

Kampus FKM UNTB
Jalan Selaparan No. 40 B Cakranegara Mataram NTB
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Mohammad Abdullah
Hp. 0812 377 8850

Abdullah, SKM, MQih
Hp. 0812 3778 850
Email: -

19 Pengda NTT DR.dr.Hyronimua A. Fernandez, M.Kes
Dr. Yuli Butu, MSc. PH

Jl Palapa No. 22 Kupang NTT 85000 Telp. 0380-833086 Fax. 825734
Atau DR.dr. H.A. Fernandes, M.Kes.
Ka. Bappeda Prov. NTT
Jalan Polisi Militer No. 2 Kupang
Telp. 0380-831712-833462
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Fernandez
Hp. 0812 3219 539
Telp. 0380-828180

  • Yendris K. Syamruth, SKIVI, M.Kes

Hp. 0813 3942 0482
Email: -

  • Dominirsep Ovidius Dodo, S.KM, M.P.H

Hp. 0852 3947 5867
Email: -

  • Vinsensius Belawa Making, S.KM.

Hp. –
Email: -

  • Maria Asumptq, S.KM

Hp. 0852 3974 7795
Email: -

20 Pengda Kalimantan Barat Eny Setyowati, SKM, M.Kes
Rizky Akbar

Dinas Kesehatan Kota Pontianak Jalan A. Yani Pontianak Kalbar.
Telp. 0561-7760528
Fax. 0561-732602
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Eny Setyowati
Hp. 08125727013

  • Rizky Akbar

Hp. 0815 2202 875
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  • Epriyanto, SKM

Hp. 0852 3487 4540
Email: -

  • Rio Mustika, SKM

Hp. –
Email: -

  • Rezki Nanda, SKM

Hp. –
Email: -

21 Pengda Kalimantan Selatan Didy Ariady, SKM., M.Kes
Kasman, SKM., M.Kes

Poltekkes Kementerian Kesehatan Banjarmasin
Jl. H. Mistar Cokrokusumo No.1 A Banjarbaru
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Kasman
Hp. 0852 2654 9077

Kasman
Hp. 0852 2654 9077
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22 Pengda Kalimantan Tengah Windarto, SKM, MA.
Djono Koesanto, MPH

Sekretariat Dinas Kesehatan Prov. Kalteng . Bidang Jamsarkes Jalan Yos Sudarso No. 9 Palangkaraya Kalteng No, tlp./fax 0536-3227604
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Windarto
Hp. 0852 4507 6881

Windarto SKM, MA.
Hp. 0852 4507 6881
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23 Pengda Kalimantan Timur Dr. Rahmat Bakhtiar, MPPM
Dr. Iwan M. Ramdan, SKep, M.Kes.

Dinas Kesehatan Prov. Kalimantan Timur. Jalan A. Wahab Sjahranie Samarinda Fax. 0541-748881 atau FKM Univ. Mulawarman
T/F.0547- 202699
Alamat Rumah Sjahrani Djedi
Jalan Jakarta Perum Korpri Loabakung Blok BN No. 23 RT. 057 Samarinda
Telp. 0541-6275519, Fax. 743810
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Rachmat Bachtiar
Hp. 081347213996
Iwan M. Ramdan
Hp. 0812 5424 118

  • Dr. Iwan M. Ramdan, SKep, M.Kes.

Hp. 0812 5424 118
Email: -

  • Rachmat Bachtiar

Hp. 0813 4721 3996
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24 Pengda Sulawesi Utara Prof. dr. Jootje M.L. Umboh, MS.
Nico Tambajong, SKM.

FKM Univ. Samratulangi Kampus Unsrat KLEAK Manado telp. 0431-827130 fax. 827129
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Prof.Dr.Umboh
Hp. 0812 430 1947
Nico T.
Hp. 0812 4400 691

Prof. dr. Jootje M.L. Umboh, MS.
Hp. 0812 430 1947
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25 Pengda Gorontalo Dr. Nurindah Rahim, MS

-
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dr. Mas'ud Idris
Hp. 085256080123
Tlp. 0435-823527, Fax. 825510

Sunarto
Hp. 0812 4419 262
Email: -

26 Pengda Sulawesi Tengah Dr. Erson Sirait, M.Kes.

Jalan Towua No. 114 Kampus STIK Indonesia Jaya Lt. 4 Sayap Barat
Palu. Tlp. / Fax 041.485603
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Erson Sirait
Hp. 0852 4227 5152

Dr. Erson Surait, M.Kes.
Hp. 0852 422 75 152
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27 Pengda Sulawesi Selatan Prof. Dr. drg. Andi Zulkifli, M.Kes.
Muhammad Ikhtiar, SKM, M.Kes

FKM Univ. Hassanudin Jalan Perintis Kemerdekaan Km 10 Makassar - Sulawesi Selatan Tlp. 0411-585658/516005 F. 586013
Fax Pasca 0411-585868
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Prof. Dr. drg. Andi Zulkifli, M.Kes.
Hp. 0813 4270 6750
Tanti astianti
Hp. 0852 9995 0212

  • Aminuddin Syah

Hp. 0852 31605 650
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  • A. Mansur Sulolipu

Hp. 0813 4257 3234
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  • Muhammad Ikhtiar

Hp. 0853 4372 3079
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28 Pengda Sulawesi Barat nowrap="nowrap" Nugroho Hamid, SKM, M.Kes
Abd. Madjid, SKM, M.Kes

Sekretariat : Desa Bambu
Jalan Poros Mamuju-Bandara
Mamuju SULBAR
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Nugroho Hamid, SKM, M.Kes
Hp. 0812 4277 8404
Abd. Madjid, SKM, M.Kes
Hp. 0813 4261 1818

Nugroho Hamid, SKM, M.Kes
Hp. 0812 4277 8404
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Abd. Madjid, SKM, M.Kes
Hp. 0813 426 11 818
Email: -

29 Pengda Sulawesi Tenggara Ramadhan Tosespu
Imran (Ketua Harian)
Dr. Nani Yuniar

Gedung FKM UNHALU, Lt.1 Kendari
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Ramadhan Tosepu
Hp. 0852 3115 4299
Dr. Nani Yuniar
Hp. 0812 3138 0635
Imran
Hp. 0813 5487 2332

  • DR. Nani Yuniar, S.Sos., M.Kes

Hp. 0812 313 80 635
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  • La Ode Ali Imran Ahmad, SKM.,M.Kes

Hp. 0813 548 72332
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30 Pengda Maluku nowrap="nowrap" Helda de Jong, SKM, M.Kes.
Billy Talarima, SKM, M.Kes

Dinkes Prov. Maluku
Jalan Dewisartika Karang Panjang Ambon Maluku
Tlp. 0911-355158

Helda
Hp. 0813 4305 4568
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Billy
Hp. 0823 9951 2775
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Billy Talarima
Hp. 0823 9951 2775
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31 Pengda Maluku Utara

-

Jl. A. M. Kamaruddin Siko Ternate Telp. 0921-23934
Fax. 328555
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Aryadi Mandaya, SKM
Hp. 0858 5534 2623
Tati Sumiyati
Telp. (0921) 326136
Hp. 0813 5609 0097

Tati Sumiyati
Hp. 0813 560 900 97
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32 Pengda Papua Drs. A.L. Rantetampang, M.Kes

Sekretariat IAKMI Papua
Jl. Raya Sentani Abepura.
Gedung Baru FKM Uncen Lt. 2
Telp/Fax. (0967) 588014
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Drs. A.L. Rantetampang, M.Kes.,
Hp. 0812 1800 593
Agus
Hp. 081344665518

Drs. A.L. Rantetampang, M.Kes
Hp. 0812 1800 593
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Agus
Hp. 0813 4466 5518
Email: -

33 Pengda Papua Barat nowrap="nowrap" Yaconias

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Yaconias
Hp. 0813 4485 4730
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Ning Santjojo
Hp. 0812 4808 8000
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Yaconias
Hp. 0813 4485 4730
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34 Pengda Kalimanatan Utara nowrap="nowrap" Pollymaart Sijabat, SKM, M.AP
Dedy Prasetya Noor, SKM

-

Pollymaart Sijabat
Hp. 0812 9041 5430
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