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Antonius Susatyo Hadi, MD
Obstetrics & Gynecology Physician in Boardman, Ohio
NPI 1033296942

Antonius Susatyo Hadi is a Obstetrics & Gynecology Physician based in Boardman, OH. Antonius Susatyo Hadi practices in Boardman, OH and has the professional credentials of MD. The NPI Number for Antonius Susatyo Hadi is 1033296942 and holds a License No. 35046065 (Ohio).

The current practice location address for Antonius Susatyo Hadi is 8401 Market St, Boardman, OH and can be reached out via phone at 330-729-4350 and via fax at 330-729-4351.

Location: 8401 Market St, Boardman, OH, 44512-6725
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033296942
Provider Name
Antonius Susatyo Hadi
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
8401 Market St, Boardman, OH, 44512-6725
Phone Number
330-729-4350
Fax Number
330-729-4351
Provider Enumeration Date
11/01/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
H087621 01 OH MEDICARE PTAN
2444519 05 OH
institution
Provider Business Practice Location Address Details
Address
8401 Market St
City
Boardman
State
Ohio
Zip
44512-6725
Phone Number
330-729-4350
Fax Number
330-729-4351
person
Provider Business Mailing Address Details
Address
8401 Market St
City
Boardman
State
Ohio
Zip
44512-6725
Phone Number
330-729-4350
Fax Number
330-729-4351
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
-
Taxonomy
207V00000X
License No.
35046065 (Ohio)
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
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