Individual
ANTONIUS SUSATYO HADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8401 MARKET ST, BOARDMAN, OH 44512-6725
(330) 729-4350
(330) 729-4351
Mailing address
8401 MARKET ST, BOARDMAN, OH 44512-6725
(330) 729-4350
(330) 729-4351
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35046065
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2444519
—
OH
01
—
H087621
MEDICARE PTAN
OH
Enumeration date
11/01/2006
Last updated
12/28/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us