You should ask yourself what is most important to you. If being with your fiance is the most important, then you should apply to all IM/FM programs wherever he/she is (and if he is in a desirable location, then you should also add programs in nearby cities). If getting training at the best IM program is the most important, then you should apply to 100+ low-tier IM and community programs broadly. The choice is up to you.
Low to mid-tier university programs. Decent step scores but you'll need something else to be considered for mid-tier programs.
I can't comment on most of your programs, but there is no point in applying for your reaches. Programs such as Georgetown/GW/Iowa/MCW etc are major reaches for you imo. Unfortunately, you suffer from 'generic application' syndrome with no stand-out features and DO to boot. Not trying to be mean but trying to be realistic. You'll get a good IM education at some of the programs you listed. It's what you make of your opportunities that really counts.
Your chances at GI are slim. Focus on kicking butt in residency, being a chief (if possible), and doing research (with focus on a couple of publications) to have a shot at GI.
Any advice for my post above? Specifically for schools like GW?