Individual
DR. MATTHEW REASE MOOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 W 5TH ST, SHERIDAN, WY 82801-2705
(307) 672-1000
Mailing address
PO BOX 514, BIG HORN, WY 82833-0514
(406) 599-9561
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9615
MT
207L00000X
Anesthesiology Physician
MD219202
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0027506
—
MT
05
—
805495000
—
ID
Enumeration date
10/20/2005
Last updated
10/09/2025
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