I have a saved search for Baltimore MD, exact location button checked.  However I keep getting hits for providers in NYC that don't even have MD as a second location.  Anyone else having this issue (or know what I'm doing wrong)?  

I think you are getting hits on Providers whose reviewer entered meeting them in a city that is neither primary nor on their visible "other cities served" list.  Scroll down her list of reviews and see their are entries that mention "Session Location" for Baltimore.
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You are getting hits for someone who is, maybe, primarily Location = New York, and then maybe "Other city" = Boston or Orlando.  But somewhere in her list of reviews you will probably find the one guy who saw her in Baltimore.  
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Personally, I think that's a good thing to know about. If she matches your other criteria and you check her website or calendar, you might find that she is returning to Baltimore at a time convenient for you.

Thank you for the detailed reply.  I had a look through the hits and all seem to be Manhattan only, but I didn't check all of the reviews yet.  I appreciate you taking the time to help.